Healthcare Provider Details
I. General information
NPI: 1194608778
Provider Name (Legal Business Name): MARYLAND FAMILY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2025
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 ST PAUL PLACE 12TH FLOOR MCAULEY TOWER
BALTIMORE MD
21202
US
IV. Provider business mailing address
301 ST PAUL PLACE MEDICAL STAFF OFFICE
BALTIMORE MD
21202
US
V. Phone/Fax
- Phone: 410-500-5500
- Fax: 410-659-5691
- Phone: 410-659-2963
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0000X |
| Taxonomy | Adolescent Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILMA
ROWE
Title or Position: DIRECTOR
Credential:
Phone: 410-332-9070