Provider Demographics
NPI:1780922583
Name:MICHAEL A TORRES MD
Entity type:Organization
Organization Name:MICHAEL A TORRES MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:410-617-0605
Mailing Address - Street 1:600 WYNDHURST AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2489
Mailing Address - Country:US
Mailing Address - Phone:410-617-0605
Mailing Address - Fax:443-773-1406
Practice Address - Street 1:4710 EIDERDOWN CT STE 160
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6222
Practice Address - Country:US
Practice Address - Phone:410-617-0605
Practice Address - Fax:855-740-1530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD423822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD335616700Medicaid