Healthcare Provider Details

I. General information

NPI: 1013135599
Provider Name (Legal Business Name): JEAN ANN BIALAS WOMENS MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MEMORIAL AVE SUITE 303
CUMBERLAND MD
21502-3765
US

IV. Provider business mailing address

600 MEMORIAL AVE SUITE 303 WOMENS MEDICAL
CUMBERLAND MD
21502-3765
US

V. Phone/Fax

Practice location:
  • Phone: 301-759-2900
  • Fax: 301-759-4850
Mailing address:
  • Phone: 410-872-9188
  • Fax: 410-872-9169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberD0051177
License Number StateMD

VIII. Authorized Official

Name: DR. JEAN ANN BIALAS
Title or Position: OWNER
Credential: MD
Phone: 301-759-2900