Healthcare Provider Details

I. General information

NPI: 1598672099
Provider Name (Legal Business Name): PELVIC GYNECOLOGY ASSOCIATES OF BALTIMORE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 KNOLL NORTH DR STE 200
COLUMBIA MD
21045-2362
US

IV. Provider business mailing address

2090 PALM BEACH LAKES BLVD STE 700
WEST PALM BEACH FL
33409-6508
US

V. Phone/Fax

Practice location:
  • Phone: 410-237-6683
  • Fax:
Mailing address:
  • Phone: 410-237-6683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JANE LAGNESE
Title or Position: SR. DIRECTOR OF RCM
Credential:
Phone: 561-422-4206