JUDY M DESTOUET (NPI# 1245267848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245267848 |
| Entity Type | Individual |
| Full Name | JUDY M DESTOUET |
| Credential | MD |
| Practice Address |
7253 Ambassador Rd Baltimore MD 21244-2710 |
| Practice Telephone | 4434361151 |
| Practice Fax Number | 4434361256 |
| Mailing Telephone | 4434361151 |
| Mailing Fax Number | 4434361256 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2014-01-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
D0043704 | MH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 182991200 | 05 |
| Street Address |
7253 AMBASSADOR RD |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21244-2710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538156559 | David Randy Tabb | Radiology | 7253 Ambassador Rd, Baltimore, MD 21244-2710 | 2005-10-04 |
| 1487296471 | Maryland Imaging Network, PC | Radiology | 7253 Ambassador Rd, Baltimore, MD 21244-2710 | 2019-10-11 |
| 1730590068 | Anna Cherian | Radiology | 7253 Ambassador Rd, Baltimore, MD 21244-2710 | 2014-05-08 |
| 1811263122 | Manuel Soto-fournier | Radiology | 7253 Ambassador Rd, Baltimore, MD 21244 | 2012-03-30 |
| 1578851192 | Puneet Singh Devgun | Internal Medicine | 7253 Ambassador Rd, Baltimore, MD 21244 | 2011-07-17 |
| 1851619522 | Edward Ahn | Internal Medicine | 7253 Ambassador Rd, Baltimore, MD 21244-2710 | 2010-05-05 |
| 1811125115 | Deirdre A. Hansen | Radiology | 7253 Ambassador Rd, Baltimore, MD 21244-2710 | 2009-06-24 |
| 1588839526 | Manjiri Mukund Didolkar | Radiology | 7253 Ambassador Rd, Baltimore, MD 21244-2710 | 2008-04-29 |
| 1598968117 | Kevin E. Jarrell | Radiology | 7253 Ambassador Rd, Baltimore, MD 21244-2710 | 2007-06-10 |
| 1790987766 | Haleema Javid | Radiology | 7253 Ambassador Rd, Baltimore, MD 21244-2710 | 2007-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235748468 | Sinnai Behavioral Health Services Inc | Psychiatric Residential Treatment Facility | 3610 Milford Road, Third Floor, Baltimore, MD 21244 | 2020-07-23 |
| 1023655370 | Flourish Healthcare Solutions, LLC | Home Health Aide | 3517 Langrehr Road, Suite 106a, Windsor Hill, MD 21244 | 2019-12-05 |
| 1265078471 | Chika Cares Pre-diabetes Workshop LLC | Public Health or Welfare | St Gabriel Church, 6950 Dogwood Rd, Windsor Mill, MD 21244 | 2019-11-22 |
| 1306318761 | Elana Rose Dorfman | Social Worker | 7205 Rutherford Road, Windsor Mill, MD 21244 | 2018-12-26 |
| 1235618406 | Stacy Solte Antonio | Physical Therapy Assistant | 7141 Security Blvd., Woodlawn, MD 21244 | 2018-08-08 |
| 1831675446 | Martha Marie Brown | Behavior Technician | 7901 Subet Rd, Windsor Mill, MD 21244 | 2018-07-17 |
| 1003306671 | Bk Faithful Enterprises Consulting, LLC | Dentist | 3120 Lord Baltimore Dr Ste 100, Baltimore, MD 21244 | 2018-05-18 |
| 1235640475 | Kingsley Awah | Home Health Aide | 7932 Dunhill Village Cir, Windsor Mill, Baltimore, MD 21244 | 2017-10-16 |
| 1316465917 | Elizabeth Duggan | Occupational Therapist | 7141 Security Blvd, Md 21244, Baltimore, MD 21244 | 2017-09-03 |
| 1326565052 | Latoya Womack | Registered Nurse | 7102 Burford Ct Apt 301, Windsor Mill, MD 21244 | 2017-08-24 |
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| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235510983 | David Jinkyu Lee | Radiology | 601 N Caroline St # 3251, Baltimore, MD 21287-0006 | 2015-06-17 |
| 1639556467 | Samarth Gola | Radiology | 601 N Caroline St Ofc 3014, Baltimore, MD 21287-0006 | 2015-04-30 |
| 1386059400 | Daniel Ryan | Radiology | 600 N. Wolfe Street Phipps Bldg, Room B-100, Baltimore, MD 21287 | 2014-06-26 |
| 1538415633 | Ammar K. Al-ibraheemi | Radiology | 601 N Wolfe St Rm 3235a, Baltimore, MD 21287-0004 | 2012-07-26 |
| 1609165042 | Sunpreet Singh Tandon | Radiology | 4940 Eastern Ave Fl 1, Baltimore, MD 21224-2735 | 2011-04-06 |
| 1639476948 | Byung Chul Yoon | Radiology | 1620 Mcelderry St Apt 515, Baltimore, MD 21205 | 2011-02-23 |
| 1730484619 | Howard Allen Davidov | Radiology | 7221 Denberg Rd, Baltimore, MD 21209-1038 | 2011-01-24 |
| 1306075056 | Elnasif Arrayeh | Radiology | 601 N Caroline St # 3235a, Baltimore, MD 21287-0006 | 2009-07-02 |
| 1922234558 | Kristin K. Porter | Radiology | Radiology Department Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287-0001 | 2009-06-10 |
| 1386884302 | Elizabeth Kristine Weihe | Radiology | 601 N Caroline St # 3142, Baltimore, MD 21287-7406 | 2009-03-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.