Provider Demographics
NPI:1447278486
Name:GARZA, MARY B (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:B
Last Name:GARZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10807 FALLS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4591
Mailing Address - Country:US
Mailing Address - Phone:410-321-9393
Mailing Address - Fax:410-825-4945
Practice Address - Street 1:10807 FALLS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4591
Practice Address - Country:US
Practice Address - Phone:410-321-9393
Practice Address - Fax:410-825-4945
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD073808L208000000X
MDD0069069208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD417910200Medicaid
NJ0083062Medicaid
PA101433664Medicaid
MD417910200Medicaid
NJ0083062Medicaid