Healthcare Provider Details

I. General information

NPI: 1619107299
Provider Name (Legal Business Name): UNION MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N CALVERT ST JPB, SUITE 210
BALTIMORE MD
21218-2867
US

IV. Provider business mailing address

201 E UNIVERSITY PKWY
BALTIMORE MD
21218-2829
US

V. Phone/Fax

Practice location:
  • Phone: 410-554-6868
  • Fax:
Mailing address:
  • Phone: 410-554-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STUART BELL
Title or Position: V. P. OF MEDICAL AFFAIRS
Credential:
Phone: 410-554-2000