DR. EDILBERTO ATIENZA JR. (NPI# 1356729040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356729040 |
| Entity Type | Individual |
| Full Name | DR. EDILBERTO ATIENZA JR. |
| Credential | M.D. |
| Practice Address |
3407 Wilkens Ave Baltimore MD 21229 |
| Mailing Address |
3407 Wilkens Ave Baltimore MD 21229-5072 |
| Practice Telephone | 2408045368 |
| Mailing Telephone | 2408045368 |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2018-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
D0084921 | MD | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1617 N Washington, Magnolia, AR 717532046 | 8705622577 |
| Street Address |
3407 WILKENS AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780687178 | Martin A. Albornoz | Internal Medicine | 3407 Wilkens Ave, Suite 300, Baltimore, MD 21229-5072 | 2005-05-31 |
| 1760879738 | Neleen Bonilla Orsal | Nurse Practitioner | 3407 Wilkens Ave, Baltimore, MD 21229-5072 | 2015-04-17 |
| 1417379777 | Omoteniola Awofolu Dds. LLC | Dentist | 3407 Wilkens Ave, Suite 205, Baltimore, MD 21229-5072 | 2014-01-06 |
| 1205023280 | Summit Ambulatory Surgical Center, LLC | Clinic/Center | 3407 Wilkens Ave, Suite 200, Baltimore, MD 21229-5072 | 2007-10-03 |
| 1942341912 | David J. Wang | Internal Medicine | 3407 Wilkens Ave, Suite 300, Baltimore, MD 21229-5072 | 2007-02-10 |
| 1427107580 | Wendy Jo Subasic | Physician Assistant | 3407 Wilkens Ave, Suite 210, Baltimore, MD 21229-5072 | 2007-01-09 |
| 1720135544 | Bishoy Gayed | Urology | 3407 Wilkens Ave, Suite 210, Baltimore, MD 21229-5072 | 2007-01-04 |
| 1437253127 | Sondra Beth Barker | Nurse Practitioner | 3407 Wilkens Ave, Suite 210, Baltimore, MD 21229-5072 | 2006-09-12 |
| 1346257540 | Avinash L. Ganti | Surgery | 3407 Wilkens Ave, Suite 300, Baltimore, MD 21229-5072 | 2006-08-01 |
| 1104830579 | Matthew R Voss | Internal Medicine | 3407 Wilkens Ave, Suite 300, Baltimore, MD 21229-5072 | 2006-07-28 |
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| 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 | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083069348 | Miranda Gordon-zigel | Family Medicine | 1420 Key Hwy, Baltimore, MD 21230-5546 | 2016-04-25 |
| 1164713608 | Kelly Danielle Ryan | Family Medicine | 9000 Franklin Square Dr, Dept of Family Medicine, Baltimore, MD 21237-3901 | 2011-05-02 |
| 1306071436 | Louis E Kovacs | Family Medicine | 3333 N Calvert St, Suite 210, Baltimore, MD 21218-2867 | 2009-05-19 |
| 1336374461 | Leonie Prao | Family Medicine | 3333 N Calvert St, Suite 210, Baltimore, MD 21218-2867 | 2009-05-19 |
| 1275694408 | Valerie Cothran | Family Medicine | 29 S Paca St, Baltimore, MD 21201-1771 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053677518 | Jonathan Damon Lawless | Family Medicine | 11120 New Hampshire Ave Ste 411, Silver Spring, MD 20904-2620 | 2012-04-09 |
| 1467644807 | Anne K. Rettig | Family Medicine | 12111 Darnestown Rd, Gaithersburg, MD 20878-2205 | 2007-08-09 |
| 1881765170 | Christian Nnamdi Nwankwo Jr. | Family Medicine | 17 Firstfield Rd, 2nd Floor, Gaithersburg, MD 20878-1774 | 2006-11-10 |
| 1265529762 | Christopher Edward Jonas | Family Medicine | 4301 Jones Bridge Rd Dept Of, Bethesda, MD 20814-4712 | 2006-10-06 |
| 1962448902 | Shahab Z Siddiqui | Family Medicine | 324 E Antietam St Ste 305, Hagerstown, MD 21740-5768 | 2006-06-20 |
| 1649256496 | John L Ferrell IIi | Family Medicine | 11300 Rockville Pike Ste 615, Rockville, MD 20852-3033 | 2005-12-22 |
| 1821502709 | Phillip Michael Morgan | Family Medicine | 1718 Belmont Ave Ste C, Windsor Mill, MD 21244-2552 | 2017-11-29 |
| 1124552302 | Phil Mor Fit | Family Medicine | 1718 Belmont Ave Ste C, Windsor Mill, MD 21244-2552 | 2017-04-14 |
| 1245609494 | University of Maryland Athletics-college Park | Family Medicine | 379 Field House Dr, College Park, MD 20742-0001 | 2015-09-17 |
| 1710375910 | University of Maryland Sports Medicine and Wellness, LLC | Family Medicine | 379 Field House Dr, College Park, MD 20742-5415 | 2014-12-23 |
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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.