Healthcare Provider Details

I. General information

NPI: 1649117912
Provider Name (Legal Business Name): GUILFORD MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 YORK RD
BALTIMORE MD
21212-4817
US

IV. Provider business mailing address

12182 HAYLAND FARM WAY
ELLICOTT CITY MD
21042-6015
US

V. Phone/Fax

Practice location:
  • Phone: 443-552-1607
  • Fax: 443-552-1585
Mailing address:
  • Phone: 443-552-1607
  • Fax: 443-552-1588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SUYI PARK
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 443-629-0858