DR. JOANN N BODURTHA (NPI# 1336225028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336225028 |
| Entity Type | Individual |
| Full Name | DR. JOANN N BODURTHA |
| Credential | M.D. |
| Practice Address |
600 N Wolfe St Blalock 1012 D Medical Genetics Baltimore MD 21287-0005 |
| Mailing Address |
Po Box 64316 Baltimore MD 21264-4316 |
| Practice Telephone | 4109551699 |
| Practice Fax Number | 4106149246 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2016-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
D73075 | MD | Allopathic & Osteopathic Physicians |
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
0101036738 | VA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 0101036738 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 049028800 | 05 | |
| VA | 6756964 | 05 |
| Street Address |
600 N WOLFE ST BLALOCK 1012 D MEDICAL GENETICS |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21287-0005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457354821 | Earl Randy Craven | Ophthalmology | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2005-05-31 |
| 1487255279 | Elizabeth Dejaeghere | Physician Assistant | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2020-11-06 |
| 1386245751 | Johns Hopkins University | Psychiatry & Neurology | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2020-11-03 |
| 1770182560 | Abdulrahman Mohammed Gomaa Abodarahim | Ophthalmology | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2020-10-22 |
| 1760081079 | Jose Daniel Llaque Salazar | Surgery | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2020-10-19 |
| 1891302402 | Everardo Hernandez Quintela | Ophthalmology | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2020-09-28 |
| 1891307997 | Abby Holland Keen | Student in an Organized Health Care Education/Training Program | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2020-08-19 |
| 1184235004 | Molly Ruhl | Physician Assistant | 600 N Wolfe St, Halsted 600, Baltimore, MD 21287-2128 | 2020-08-13 |
| 1083224596 | Johns Hopkins University | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2020-08-10 | |
| 1265041032 | Carlos Fairen Oro | Surgery | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2020-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1316572175 | Sarah Branigan | Pediatrics | Johns Hopkins Children's Center, 1800 Orleans Street, Baltimore, MD 21287 | 2020-03-11 |
| 1790318657 | Margaret Geraldine Keane | Internal Medicine | Sheikh Zayed Tower, 1800 Orleans St, Baltimore, MD 21287 | 2020-02-19 |
| 1699322636 | Lakeya Mcgill | Student in an Organized Health Care Education/Training Program | 600 North Wolfe St, Phipps 174, Baltimore, MD 21287 | 2019-08-23 |
| 1245882406 | Ranim Amer Ibrahim Alsaad | Student in an Organized Health Care Education/Training Program | 1800 Orleans Street - Johns Hopkins Hospital, Tower 110, Baltimore, MD 21287 | 2019-07-09 |
| 1992364004 | Anthony David Pisaniello | Student in an Organized Health Care Education/Training Program | 1800 Orleans St, Johns Hopkins Hospital, Baltimore, MD 21287 | 2019-06-12 |
| 1255990503 | Ethan Tumarkin | Student in an Organized Health Care Education/Training Program | 600 N. Wolfe St./halsted 500, Baltimore, MD 21287 | 2019-06-11 |
| 1629636386 | Kathleen Anne Malloy | Counselor | Jhh 600 N. Wolfe St., Cpp- Meyer 144, Baltimore, MD 21287 | 2019-05-29 |
| 1285298489 | Ashleigh Graham | Student in an Organized Health Care Education/Training Program | Pathology Building, Rm 401, 600 N. Wolfe Street, Baltimore, MD 21287 | 2019-04-24 |
| 1851955066 | Seena Tabibi | Student in an Organized Health Care Education/Training Program | Pathology Department Johns Hopkins University Som, Pathology Building Rm 401, 600 North Wolfe Street, Baltimore, MD 21287 | 2019-04-24 |
| Find all providers in zip 21287 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912103177 | Johns Hopkins University | Medical Genetics | 1812 Ashland Ave Ste 200, Baltimore, MD 21205-1506 | 2007-06-25 |
| 1255388401 | Shama Jari | Medical Genetics | 6701 N Charles St Ste 2310, Baltimore, MD 21204-6808 | 2006-05-30 |
| 1700226636 | Nara Lygia De Macena Sobreira | Medical Genetics | 733 N Broadway, Baltimore, MD 21205-1832 | 2013-06-25 |
| 1568693331 | Susan Roseanne Panny | Medical Genetics | 201 W Preston St, Suite 424, Baltimore, MD 21201-2301 | 2009-07-28 |
| 1265643787 | Hans Tomas Bjornsson | Medical Genetics | 600 N Wolfe St, Cmsc 2-124, Baltimore, MD 21287-0005 | 2007-05-25 |
| 1982816559 | Sinai Hospital of Baltimore | Medical Genetics | 2401 W Belvedere Ave, Baltimore, MD 21215-5216 | 2007-05-04 |
| 1780615427 | Christiane Theda | Medical Genetics | 600 N Wolfe St, Neonatology - Nelson 2-133, Baltimore, MD 21287-0005 | 2006-07-05 |
| 1114954906 | Harry C Dietz IIi | Medical Genetics | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2006-06-27 |
| 1811923907 | Tao Wang | Medical Genetics | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2006-06-23 |
| 1174568083 | Garry R Cutting | Medical Genetics | 601 N Caroline St, Baltimore, MD 21287-0006 | 2006-06-17 |
| Find all providers in BALTIMORE | ||||
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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.