DR. MARC DARYL TAN ESTIOKO (NPI# 1326497629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326497629 |
| Entity Type | Individual |
| Full Name | DR. MARC DARYL TAN ESTIOKO |
| Credential | M.D. |
| Practice Address |
2200 Kernan Dr Baltimore MD 21207-6665 |
| Practice Telephone | 4104486824 |
| Mailing Telephone | 4104486824 |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2020-07-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | MT210453 | PA | Student, Health Care |
| Street Address |
2200 KERNAN DR |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21207-6665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942202692 | Kernan Dentistry | Clinic/Center | 2200 Kernan Dr, Dental Suite T500, Baltimore, MD 21207-6665 | 2005-08-12 |
| 1881207868 | Neima Hinda Brody | Speech-Language Pathologist | 2200 Kernan Dr, Baltimore, MD 21207-6665 | 2020-08-28 |
| 1255982690 | Amy Olzmann | Clinical Neuropsychologist | 2200 Kernan Dr, Baltimore, MD 21207-6665 | 2019-09-26 |
| 1669036836 | Idowu Awolusi | Nurse Practitioner | 2200 Kernan Dr, Baltimore, MD 21207-6665 | 2019-04-23 |
| 1124583950 | Carolyn Kaye Gibson | Internal Medicine | 2200 Kernan Dr, Baltimore, MD 21207-6665 | 2019-02-06 |
| 1275097784 | Kayla Marie Stolins | Occupational Therapist | 2200 Kernan Dr, Baltimore, MD 21207-6665 | 2019-01-29 |
| 1669936571 | Elizabeth Wells Bihn | Speech-Language Pathologist | 2200 Kernan Dr, Baltimore, MD 21207-6665 | 2019-01-24 |
| 1275007833 | Nikkie Dorsey | Occupational Therapist | 2200 Kernan Dr, Baltimore, MD 21207-6665 | 2019-01-17 |
| 1104390905 | Allison Jean | Occupational Therapist | 2200 Kernan Dr, Baltimore, MD 21207-6665 | 2019-01-15 |
| 1548734361 | Lauren Sirriannia | Occupational Therapist | 2200 Kernan Dr, Baltimore, MD 21207-6665 | 2019-01-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821613373 | Keys Development Ta | Case Management | 7501 Liberty Rd Ste F/g, Keys Development Ta LLC., Gwynn Oak, MD 21207 | 2020-06-10 |
| 1891328431 | Day-by-day Healthcare LLC | Home Health Aide | 6817 Fox Meadow Rd, Gwynnoak, Baltimore, MD 21207 | 2020-02-21 |
| 1366005944 | Lacey Murphy | Social Worker | 6201 Liberty Road, Baltimore, MD 21207 | 2019-04-18 |
| 1811453368 | Pamela Powell | Social Worker | 5025 Dickey Hill Rd, Baltimore, MD 21207 | 2019-02-20 |
| 1568932176 | Reflections Counseling & Consulting | Community/Behavioral Health | 6901 Brightway, Unit F, Gwynn Oak, MD 21207 | 2018-11-27 |
| 1255849394 | Therapetic Wellness Services | Community/Behavioral Health | 4909 Liberty Heights Ave, Baltimore, MD 21207 | 2018-01-10 |
| 1922525252 | Passionate Hands Transitional Housing | Clinic/Center | 4711 Liberty Heights Avenue, Baltimore, MD 21207 | 2017-08-28 |
| 1528427689 | Stephen James Allen | Occupational Therapy Assistant | 4107 Liberty Heights Ave, Baltimore, MARYLAND 21207 | 2016-02-17 |
| 1255720439 | Dawn James | Counselor | 6401 Dogwood Road, Suite 201, Gwynn Oak, MD 21207 | 2015-01-12 |
| 1407251168 | Allcare International, Inc | Day Training, Developmentally Disabled Services | 3402 Milford Ave, Baltimore, MD 21207 | 2014-10-23 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355879 | Cristina Diana Ghinda | Student in an Organized Health Care Education/Training Program | 600 N Wolfe St Bldg 8, Baltimore, MD 21287-0005 | 2020-10-27 |
| 1265043160 | Kathryn Ann Ritchie | Student in an Organized Health Care Education/Training Program | 1750 E Fairmount Ave Dept Of, Baltimore, MD 21231-1534 | 2020-08-13 |
| 1053929372 | Rod Guerrero Salgado | Student in an Organized Health Care Education/Training Program | 140 N Luzerne Ave, Baltimore, MD 21224-1147 | 2020-07-22 |
| 1518585470 | Meshref Ayed Alshehri | Student in an Organized Health Care Education/Training Program | 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-07-08 |
| 1174140503 | Thomas Dimitrios Zaikos | Student in an Organized Health Care Education/Training Program | Pathology Building Rm. 401, 600 N. Wolfe Street, Baltimore, MD 21287 | 2020-07-01 |
| 1649897158 | Michael William Mikula | Student in an Organized Health Care Education/Training Program | Pathology Bldg., Rm. 401, 600 N Wolfe St, Baltimore, MD 21287-0005 | 2020-06-30 |
| 1154948743 | Kamilah S Brown | Student in an Organized Health Care Education/Training Program | 437 E Lorraine Ave, Baltimore, MD 21218-4713 | 2020-06-29 |
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1467077479 | Nashedra Barry | Student in an Organized Health Care Education/Training Program | 301 N Charles St Apt M1, Baltimore, MD 21201-4397 | 2020-06-15 |
| 1205451804 | Ryan Robert Keoni Ingle | Student in an Organized Health Care Education/Training Program | 29 S Greene St Ste 400, Baltimore, MD 21201-1504 | 2020-06-10 |
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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.