Provider Demographics
NPI:1720134919
Name:FITZGERALD, APRIL SULLIVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:SULLIVAN
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:APRIL
Other - Middle Name:MARLENE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 64264
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4264
Mailing Address - Country:US
Mailing Address - Phone:410-583-2774
Mailing Address - Fax:
Practice Address - Street 1:10753 FALLS RD
Practice Address - Street 2:SUITE 325
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4535
Practice Address - Country:US
Practice Address - Phone:410-583-2774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065251207R00000X
MA155484207R00000X
VA0101237499207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD013407400Medicaid
MAH10585Medicare UPIN
MDKR65Q111Medicare PIN