Healthcare Provider Details

I. General information

NPI: 1750335402
Provider Name (Legal Business Name): SAINT PAUL PLACE SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SAINT PAUL PL EMERGENCY DEPT.
BALTIMORE MD
21202-2102
US

IV. Provider business mailing address

PO BOX 64075
BALTIMORE MD
21264-4075
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9809
  • Fax: 410-545-5162
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT A EDWARDS
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 410-951-1773