Provider Demographics
NPI:1730512971
Name:TITUS, GINGER (PT)
Entity type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:
Last Name:TITUS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:GINGER
Other - Middle Name:
Other - Last Name:GALADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:28577 MARYS CT
Mailing Address - Street 2:SUITE 5
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7499
Mailing Address - Country:US
Mailing Address - Phone:410-885-6103
Mailing Address - Fax:410-885-4669
Practice Address - Street 1:401 MARVEL CT
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4048
Practice Address - Country:US
Practice Address - Phone:410-820-4449
Practice Address - Fax:410-820-4330
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG5400008OtherCAREFIRST
MD323110ZBPGOtherMEDICARE
MD280724OtherJOHN HOPKINS
MD422217200Medicaid