Port, Ava

Port, Ava is an individual health care provider with primary practice located at 827 Linden Ave Floor 2, South, Baltimore MD 21201-4606. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Port, Ava can be contacted via phone (443) 682-6800.

Contact Information

Primary practice address
827 Linden Ave Floor 2, South Baltimore MD 21201-4606
Phone: (443) 682-6800
Fax: (443) 552-2991
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X D74506 Maryland

Profile Details

NPI number 1457528358
LBN Legal business name Port, Ava
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2008
Last updated Jan 5th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457528358 NPPES
Maryland MEDICAID 332136300
Maryland Other S062-0486

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