Healthcare Provider Details

I. General information

NPI: 1427865773
Provider Name (Legal Business Name): UNIVERSITY OF MARYLAND PHYSICIANS P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 WESTMINSTER PIKE STE 106
REISTERSTOWN MD
21136-1060
US

IV. Provider business mailing address

PO BOX 64442
BALTIMORE MD
21264-4442
US

V. Phone/Fax

Practice location:
  • Phone: 410-876-0086
  • Fax: 410-871-0030
Mailing address:
  • Phone: 410-328-8040
  • Fax: 410-328-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ADAM KAUFMAN
Title or Position: DIRECTOR OF PROFESSIONAL FEES
Credential:
Phone: 410-328-8040