Healthcare Provider Details

I. General information

NPI: 1124952346
Provider Name (Legal Business Name): GLAUCOMA CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 N CHARLES ST STE 302
BALTIMORE MD
21204-5804
US

IV. Provider business mailing address

6565 N CHARLES ST STE 302
BALTIMORE MD
21204-5804
US

V. Phone/Fax

Practice location:
  • Phone: 410-825-9225
  • Fax: 410-825-9229
Mailing address:
  • Phone: 410-825-9225
  • Fax: 410-825-9229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: HAILEY BILDERBACK
Title or Position: BILLING MANAGER
Credential:
Phone: 443-470-9374