Basic Information
| Provider Information | |||||||||
| NPI: | 1801334040 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY OF MARYLAND MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22 S GREENE ST | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011544 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 22 S GREENE ST | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103288667 | ||||||||
| FaxNumber: | 4103286878 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2017 | ||||||||
| LastUpdateDate: | 02/08/2017 | ||||||||
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| AuthorizedOfficialLastName: | ANDRUS | ||||||||
| AuthorizedOfficialFirstName: | ALLISON | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR, MEDICAL STAFF SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 4103281151 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UNIVERSITY OF MARYLAND MEDICAL SYSTEM | ||||||||
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| AuthorizedOfficialCredential: | CPMSM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | R173953 | MD | Y | Hospitals | General Acute Care Hospital |
No ID Information.