Provider Demographics
NPI:1992809008
Name:MOND, CHAIM BERNARD (MD)
Entity type:Individual
Prefix:
First Name:CHAIM
Middle Name:BERNARD
Last Name:MOND
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 1:2835 SMITH AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1453
Mailing Address - Country:US
Mailing Address - Phone:410-525-1691
Mailing Address - Fax:410-358-1016
Practice Address - Street 1:2835 SMITH AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-1453
Practice Address - Country:US
Practice Address - Phone:410-525-1691
Practice Address - Fax:410-358-1016
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0037019207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD510901Medicaid
MD4015Medicare ID - Type Unspecified
MD510901Medicaid