Healthcare Provider Details

I. General information

NPI: 1124061361
Provider Name (Legal Business Name): PAUL F. HESS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 LOCH RAVEN BLVD
BALTIMORE MD
21239-2905
US

IV. Provider business mailing address

10251 GLOBE DR
ELLICOTT CITY MD
21042-2111
US

V. Phone/Fax

Practice location:
  • Phone: 410-532-4040
  • Fax: 410-532-4962
Mailing address:
  • Phone: 410-750-1586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR148975
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: