Healthcare Provider Details
I. General information
NPI: 1245044171
Provider Name (Legal Business Name): UNIVERSITY OF MARYLAND PEDIATRIC ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/03/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
226 SCHILLING CIR
HUNT VALLEY MD
21031-8647
US
IV. Provider business mailing address
PO BOX 62063
BALTIMORE MD
21264-2063
US
V. Phone/Fax
- Phone: 410-448-6400
- Fax: 410-786-4840
- Phone: 410-706-5181
- Fax: 410-706-5103
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 281PC2000X |
| Taxonomy | Children's Chronic Disease Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARGIE
OLLER
BURR
Title or Position: DIRECTOR OF PROFESSIONAL FEES
Credential:
Phone: 410-706-5181