Mark Joel Illuminati, MD

General Practice Physician · Baltimore, MD

Individual Active NPI

NPI number 1518077320

Practice location

1212 Shore Rd
Baltimore, MD 21220-5526
Phone
(410) 780-3972

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NPI record

NPI
1518077320
Entity type
Individual (Type 1)
Enumeration date
August 30, 2006
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Physician Primary 208D00000X D35832 MD

About Dr. Illuminati

Mark Joel Illuminati, MD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Physician (code 208D00000X). The practice location is 1212 Shore Rd, Baltimore, MD 21220-5526. The NPI number 1518077320 was assigned on August 30, 2006 and the record was last updated on July 8, 2007.

Dr. Illuminati lists a license in the registry: #D35832 (MD) for General Practice Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Joel Illuminati, MD?

The NPI number is 1518077320.

What is the phone number of Dr. Illuminati?

The phone number listed for the practice location is (410) 780-3972.

Where is Dr. Illuminati located?

1212 Shore Rd, Baltimore, MD 21220-5526.

What is the taxonomy code for Dr. Illuminati?

The primary taxonomy code is 208D00000X – General Practice Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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