DR. MARC JUDAH FISHMAN (NPI# 1649317264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649317264 |
| Entity Type | Individual |
| Full Name | DR. MARC JUDAH FISHMAN |
| Credential | M.D. |
| Practice Address |
3800 Frederick Avenue Na Baltimore MD 21229-3618 |
| Mailing Address |
3800 Frederick Avenue Na Baltimore MD 21229 |
| Practice Telephone | 4102331400 |
| Practice Fax Number | 4102335583 |
| Mailing Telephone | 4102331400 |
| Mailing Fax Number | 4102335583 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
MD19227 | DC | Allopathic & Osteopathic Physicians |
| X | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
D0038913 | MD | Allopathic & Osteopathic Physicians |
| X | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
D0038913 | MD | Allopathic & Osteopathic Physicians |
| X | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD19227 | DC | Allopathic & Osteopathic Physicians |
| X | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
MD19227 | DC | Allopathic & Osteopathic Physicians |
| X | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
D0038913 | MD | Allopathic & Osteopathic Physicians |
| X | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD19227 | DC | Allopathic & Osteopathic Physicians |
| X | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
D0038913 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CONTROLLED SUBSTANCE REG | BF2501725 XF2501725 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801013735 | Marc L Fishman | Internal Medicine | 670 Nw 101st Ter, Plantation, FL 33324-1060 | 2007-04-20 |
| Street Address |
3800 FREDERICK AVENUE NA |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21229-3618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285116616 | Joelle Bonnett | Social Worker | 3800 Frederick Avenue, Baltimore, MD 21229 | 2018-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265068373 | Bodyworks Medical | Clinic/Center | St. Agnes Medical Center, 3455 Wilkens Ave Suite 100, Baltimore, MD 21229 | 2020-03-20 |
| 1750932430 | Amanda Felix | Nurse Practitioner | 5411 Old Frederick Road, Catonsville, MD 21229 | 2019-09-24 |
| 1497317853 | Wakeelat A Adeoye | Nurse Practitioner | 5411 0ld Fredrick Rd, Suite 7, Baltimore, MD 21229 | 2019-07-05 |
| 1598328080 | Oprah Cherelle Keyes | Social Worker | 4511 Birchwood Drive, Baltimore, MD 21229 | 2019-04-19 |
| 1477051779 | Shahin Vohara | Dentist | Dental Dreams, 4510 Edmondson Avenue, Edmondson Village Shopping Center, Baltimore, MD 21229 | 2018-02-01 |
| 1386179299 | Sharon Mccollough | Counselor | 3219 Phelps Lane, First Floor, Baltimore, MD 21229 | 2017-04-28 |
| 1184175697 | Yekeen Odewale | Registered Nurse | 5411 Old Frederick Rd Ste 7, Baltimore, MD 21229 | 2016-10-19 |
| 1942608070 | Charity Ashe | Social Worker | 4024 Colborne Rd, Baltimore, MD 21229 | 2014-12-05 |
| 1376947127 | Sumanya Venkat Rao | Dentist | 4510 Edmondson Ave, Baltimore, MD 21229 | 2014-10-21 |
| 1497091573 | Anita Phillips | Social Worker | 5110 Frederick Avenue, Baltimore, MD 21229 | 2012-12-18 |
| Find all providers in zip 21229 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861599490 | Rhonda Lynn Allen | Psychiatry & Neurology | 5401 Loch Raven Blvd Fl 2, Baltimore, MD 21239-2902 | 2006-09-17 |
| 1508811936 | Maryland Treatment Centers, Inc. | Psychiatry & Neurology | 3800 Frederick Ave, Baltimore, MD 21229-3618 | 2006-05-24 |
| 1659333946 | David A. Gorelick | Psychiatry & Neurology | 5500 Nathan Shock Dr, Baltimore, MD 21224-6823 | 2006-04-04 |
| 1881080653 | Darryl M Coleman Md Pa | Psychiatry & Neurology | 2125 Maryland Ave, Suites 109 & 110, Baltimore, MD 21218-5634 | 2015-04-08 |
| 1003061771 | Priscilla Waldo Sheldon | Psychiatry & Neurology | 1001 W Pratt St, Baltimore, MD 21223-2679 | 2008-11-22 |
| 1205097391 | Aisosioya A Williams | Psychiatry & Neurology | 1501 Division St, Baltimore, MD 21217-3121 | 2008-06-20 |
| 1184801813 | Neeraj Gandotra | Psychiatry & Neurology | 4940 Eastern Ave, Jhbmc, Baltimore, MD 21224-2735 | 2008-01-24 |
| 1508950015 | Marian Currens | Psychiatry & Neurology | 827 Linden Ave, Baltimore, MD 21201-4606 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740631951 | Carrie Schmitt | Psychiatry & Neurology | 8470 Dorsey Run Rd, Jessup, MD 20794-9486 | 2016-06-29 |
| 1871999276 | Bergand Group | Psychiatry & Neurology | 1803 Harford Rd, Fallston, MD 21047 | 2014-11-12 |
| 1578876264 | Belitehorizonmedicalcenter | Psychiatry & Neurology | 26825 Pointlook Out Road, Stee, Leonardtown, MD 20650 | 2010-07-22 |
| 1164688677 | Jack Laurence Wapner | Psychiatry & Neurology | 11100 Liberty Rd, Suite F, Randallstown, MD 21133-1026 | 2008-08-04 |
| 1003018813 | Donald Harry Taylor | Psychiatry & Neurology | 4545 Crain Hwy, Substance Abuse Services, White Plains, MD 20695-1050 | 2007-06-04 |
| 1831284769 | Syed Asif H Ali | Psychiatry & Neurology | 13102 Autumn Dr, Silver Spring, MD 20904-3307 | 2006-10-04 |
| 1952404840 | Samathanam N Abraham | Psychiatry & Neurology | 13207 Valley Dr, Rockville, MD 20850-3626 | 2006-09-06 |
| 1174634869 | Indu Mago Sud | Psychiatry & Neurology | 17958 Pond Rd, Ashton, MD 20861-9756 | 2006-08-31 |
| 1619082005 | Maryland Treatment Centers, Inc. | Psychiatry & Neurology | 14703 Avery Rd, Rockville, MD 20853-3605 | 2006-08-19 |
| 1063997708 | The Bergand Group LLC | Psychiatry & Neurology | 1300 York Rd, Lutherville, MD 21093-6016 | 2018-09-28 |
| Find all providers with the same taxonomy | ||||
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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.