Provider Demographics
NPI:1811971898
Name:FIELDS, ABBIE L (MD)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:L
Last Name:FIELDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 W BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5228
Mailing Address - Country:US
Mailing Address - Phone:410-601-9030
Mailing Address - Fax:410-601-8576
Practice Address - Street 1:2411 W BELVEDERE AVE
Practice Address - Street 2:MOWER 206
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5228
Practice Address - Country:US
Practice Address - Phone:410-601-9030
Practice Address - Fax:410-601-8576
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041449174400000X
VA0101238598207VX0201X
MDD41449207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010207797Medicaid
F28486Medicare UPIN
VA010207797Medicaid
VAP00316920Medicare PIN