Healthcare Provider Details
I. General information
NPI: 1275355828
Provider Name (Legal Business Name): GREATER BALTIMORE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2024
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6535 N CHARLES ST STE 250
BALTIMORE MD
21204-5829
US
IV. Provider business mailing address
6701 N CHARLES STREET S CHAPMAN BUILDING STE 102
BALTIMORE MD
21204
US
V. Phone/Fax
- Phone: 443-849-8400
- Fax:
- Phone: 443-849-2459
- Fax: 443-849-3138
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURIE
BEYER
Title or Position: EVP & CFO
Credential:
Phone: 443-849-2519