Provider Demographics
NPI:1154695906
Name:DREW, ERIN RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:RENEE
Last Name:DREW
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:PO BOX 942
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-0710
Mailing Address - Country:US
Mailing Address - Phone:410-902-4485
Mailing Address - Fax:410-902-4485
Practice Address - Street 1:301 SAINT PAUL PL
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2102
Practice Address - Country:US
Practice Address - Phone:410-902-4485
Practice Address - Fax:410-902-4485
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-25
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041986208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD201141700Medicaid