Healthcare Provider Details

I. General information

NPI: 1306081328
Provider Name (Legal Business Name): GRACE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 W BALTIMORE ST
BALTIMORE MD
21223-1558
US

IV. Provider business mailing address

2000 W BALTIMORE ST
BALTIMORE MD
21223-1558
US

V. Phone/Fax

Practice location:
  • Phone: 410-362-3000
  • Fax:
Mailing address:
  • Phone: 410-362-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHELLE BERKLEY-BROWN
Title or Position: VP OPERATIONS
Credential:
Phone: 410-362-3378