Healthcare Provider Details

I. General information

NPI: 1265215867
Provider Name (Legal Business Name): THE BIRTH MARK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N HAVEN ST STE 104
BALTIMORE MD
21224-1670
US

IV. Provider business mailing address

1 N HAVEN ST STE 104
BALTIMORE MD
21224-1670
US

V. Phone/Fax

Practice location:
  • Phone: 202-718-4708
  • Fax:
Mailing address:
  • Phone: 202-718-4708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DR. WENDY POST
Title or Position: CEO
Credential:
Phone: 202-718-4708