Healthcare Provider Details

I. General information

NPI: 1114871118
Provider Name (Legal Business Name): UNIV OF MARYLAND OTORHINOLARYNGOLOGY HEAD & NECK SURGERY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 W REDWOOD ST STE 370
BALTIMORE MD
21201-7024
US

IV. Provider business mailing address

PO BOX 64693
BALTIMORE MD
21264-4693
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6897
  • Fax: 410-328-2109
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: KAROL ZIMMERMAN
Title or Position: DIRECTOR
Credential:
Phone: 667-214-1620