Healthcare Provider Details

I. General information

NPI: 1427004746
Provider Name (Legal Business Name): SAINT PAUL PLACE SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 SAINT PAUL PL LOWER LEVEL
BALTIMORE MD
21202-2001
US

IV. Provider business mailing address

PO BOX 824173
PHILADELPHIA PA
19182-4173
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9055
  • Fax: 410-576-5288
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN DEIBEL
Title or Position: EXECUTIVE VICE PRESIDENT & CFO
Credential:
Phone: 410-659-2905