Healthcare Provider Details
I. General information
NPI: 1245277870
Provider Name (Legal Business Name): SAINT PAUL PLACE SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 SAINT PAUL PL DEPT OF GENERAL SURGERY
BALTIMORE MD
21202-2102
US
IV. Provider business mailing address
PO BOX 64075
BALTIMORE MD
21264-4075
US
V. Phone/Fax
- Phone: 410-332-9265
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
A
EDWARDS
Title or Position: SR, VP
Credential:
Phone: 410-951-1773