Healthcare Provider Details

I. General information

NPI: 1326854399
Provider Name (Legal Business Name): UNIVERSITY OF MARYLAND PHYSICIANS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5890 WATERLOO RD
COLUMBIA MD
21045-2617
US

IV. Provider business mailing address

PO BOX 64442
BALTIMORE MD
21264-4442
US

V. Phone/Fax

Practice location:
  • Phone: 667-214-2100
  • Fax: 410-799-9097
Mailing address:
  • Phone: 410-328-8040
  • Fax: 410-328-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ADAM KAUFMAN
Title or Position: DIRECTOR OF PROFESSIONAL FEES
Credential:
Phone: 410-328-8040