Healthcare Provider Details

I. General information

NPI: 1609872357
Provider Name (Legal Business Name): MERCY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SAINT PAUL PL
BALTIMORE MD
21202-2102
US

IV. Provider business mailing address

PO BOX 222
BALTIMORE MD
21203-0222
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9000
  • Fax: 410-545-4254
Mailing address:
  • Phone: 410-332-9000
  • Fax: 410-545-5254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number08861
License Number StateMD

VIII. Authorized Official

Name: DR. MARK F KERN
Title or Position: CLINICAL COORD. ANTICOAGULATION SVC
Credential: PHARM D
Phone: 410-332-9149