Healthcare Provider Details

I. General information

NPI: 1881634657
Provider Name (Legal Business Name): BALTIMORE MEDICAL & SURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 OSLER DR STE 406
TOWSON MD
21204-7703
US

IV. Provider business mailing address

7600 OSLER DR STE 406
TOWSON MD
21204-7703
US

V. Phone/Fax

Practice location:
  • Phone: 410-821-8444
  • Fax: 410-821-8447
Mailing address:
  • Phone: 410-821-8444
  • Fax: 410-821-8447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ZIAD K MIRZA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-821-8444