Healthcare Provider Details
I. General information
NPI: 1245286566
Provider Name (Legal Business Name): SAINT PAUL PLACE SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 SAINT PAUL PL POB 514
BALTIMORE MD
21202-2102
US
IV. Provider business mailing address
PO BOX 64075
BALTIMORE MD
21264-4075
US
V. Phone/Fax
- Phone: 410-332-9500
- Fax: 410-545-5161
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
A
EDWARDS
Title or Position: SR VP
Credential:
Phone: 410-951-1773