Healthcare Provider Details

I. General information

NPI: 1811756232
Provider Name (Legal Business Name): UPMC WESTERN MARYLAND HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 NATIONAL HWY STE 680
LAVALE MD
21502-7618
US

IV. Provider business mailing address

12501 WILLOWBROOK RD FL 3
CUMBERLAND MD
21502-2506
US

V. Phone/Fax

Practice location:
  • Phone: 240-362-0288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA T CALLOWAY
Title or Position: DIRECTOR
Credential:
Phone: 412-432-5864