Healthcare Provider Details

I. General information

NPI: 1740235274
Provider Name (Legal Business Name): UNIVERSITY OF MARYLAND ORTHOPAEDIC ASSOCIATES P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

PO BOX 64134
BALTIMORE MD
21264-4134
US

V. Phone/Fax

Practice location:
  • Phone: 667-214-2732
  • Fax: 410-448-6296
Mailing address:
  • Phone: 667-214-2732
  • Fax: 410-448-6296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA GODMAN
Title or Position: MANAGER
Credential:
Phone: 667-214-2732