Provider Demographics
NPI:1841302528
Name:ULANOW, ROBIN MARIANNE (MD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:MARIANNE
Last Name:ULANOW
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 1:200 HOSPITAL DR
Mailing Address - Street 2:SUITE 510
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5884
Mailing Address - Country:US
Mailing Address - Phone:410-761-8382
Mailing Address - Fax:410-760-8469
Practice Address - Street 1:200 HOSPITAL DR
Practice Address - Street 2:SUITE 510
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5884
Practice Address - Country:US
Practice Address - Phone:410-761-8382
Practice Address - Fax:410-760-8469
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD22680174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE4030001OtherBCBS FEP
MD100001973OtherRR MEDICARE
MD27592-1700Medicaid
MD8724RMOtherCAREFIRST BCBS
MD27592-1700Medicaid