Healthcare Provider Details

I. General information

NPI: 1730824400
Provider Name (Legal Business Name): GBMC HOSPITAL BASED SERVICES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 N CHARLES ST
BALTIMORE MD
21204-6808
US

IV. Provider business mailing address

6701 N CHARLES ST S. CHAPMAN BUILDING STE 102
BALTIMORE MD
21204-6808
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURIE R BEYER
Title or Position: EVP & CFO
Credential:
Phone: 443-849-2519