Provider Demographics
NPI:1770977365
Name:PHILOGENE, MARY CARMELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY CARMELLE
Middle Name:
Last Name:PHILOGENE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:MARY CARMELLE
Other - Middle Name:
Other - Last Name:NEPTUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2041 E MONUMENT ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-2222
Mailing Address - Country:US
Mailing Address - Phone:410-955-3600
Mailing Address - Fax:410-955-0431
Practice Address - Street 1:2041 E MONUMENT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-2222
Practice Address - Country:US
Practice Address - Phone:410-955-3600
Practice Address - Fax:410-955-0431
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist