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NPI Code Detail

MEDICARE: NEUROSURGICAL SPECIALTY SERVICES, LLC

MEDICARE: NEUROSURGICAL SPECIALTY SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207T00000XNeurological Surgery Physician

General Provider Information

NPI Number : 1306719398
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEUROSURGICAL SPECIALTY SERVICES, LLC
Provider Business Mailing Address
First Line : 301 ST PAUL PLACE
Second Line : MEDICAL STAFF OFFICE
City : BALTIMORE
State : MD
Zip : 21202-2102
Country : US
Telephone Number : 410-659-2963
Fax Number : 410-332-9789
Provider Business Practice Location Address
First Line : 2800 SOLLERS POINT RD
Second Line :
City : DUNDALK
State : MD
Zip : 21222-4647
Country : US
Telephone Number : 410-332-9717
Fax Number : 410-659-1172
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT/CFO
Name : JUSTIN DEIBEL
Credential :
Telephone Number : 410-659-2905
Provider Enumeration Date : 09/25/2025
Last Update Date : 09/25/2025

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Directions to “NEUROSURGICAL SPECIALTY SERVICES, LLC ” Practice Location

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