Provider Demographics
NPI:1538964051
Name:NATH, SIDDHARTH (MD, PHD)
Entity type:Individual
Prefix:
First Name:SIDDHARTH
Middle Name:
Last Name:NATH
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-955-5494
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:JOHNS HOPKINS HOSPITAL, WILMER EYE INSTITUTE
Practice Address - Street 2:600 NORTH WOLFE ST
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:410-955-5494
Practice Address - Fax:410-614-9172
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0104768207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty