Healthcare Provider Details
I. General information
NPI: 1336931989
Provider Name (Legal Business Name): UNIVERSITY OF MARYLAND PHYSICIANS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 GARRETT AVE
LA PLATA MD
20646-5960
US
IV. Provider business mailing address
PO BOX 64442
BALTIMORE MD
21264-4442
US
V. Phone/Fax
- Phone: 301-609-4000
- Fax:
- Phone: 410-328-8040
- Fax: 410-328-9191
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0008X |
| Taxonomy | Hepatology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADAM
KAUFMAN
Title or Position: DIRECTOR OF PROFESSIONAL FEES
Credential:
Phone: 410-328-8040