Provider Demographics
NPI:1427481688
Name:PRATT, RAYMOND D (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:D
Last Name:PRATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 E CHASE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3808
Mailing Address - Country:US
Mailing Address - Phone:410-547-1161
Mailing Address - Fax:
Practice Address - Street 1:208 E CHASE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3808
Practice Address - Country:US
Practice Address - Phone:410-547-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301102128207RN0300X
MDD0029842207RN0300X
PAMD424127207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology