Healthcare Provider Details
I. General information
NPI: 1891565040
Provider Name (Legal Business Name): GMS HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/08/2024
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7600 OSLER DR STE 105
TOWSON MD
21204-7705
US
IV. Provider business mailing address
2012 S TOLLGATE RD STE 100
BEL AIR MD
21015-5901
US
V. Phone/Fax
- Phone: 888-943-0066
- Fax: 888-943-0077
- Phone: 443-943-0066
- Fax: 443-943-0077
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
L
SEYMORE
Title or Position: PRINCIPLE
Credential: MD
Phone: 410-808-0248