Provider Demographics
NPI:1124122494
Name:CORDERO-PARRISH, CATHERINE A (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:A
Last Name:CORDERO-PARRISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3100 WYMAN PARK DRIVE
Mailing Address - Street 2:SUITE 359A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211
Mailing Address - Country:US
Mailing Address - Phone:410-338-3016
Mailing Address - Fax:410-338-3420
Practice Address - Street 1:1501 S CLINTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-5730
Practice Address - Country:US
Practice Address - Phone:410-522-9940
Practice Address - Fax:410-522-5681
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD33167208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408191900Medicaid
GL59Medicare ID - Type Unspecified
D78051Medicare UPIN