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General NPI Number Information
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NPI Number | 1225662828
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Entity Type | Organization
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Legal Business Name | FEDERAL HILL MEDICAL CENTER
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 724 A LIGHT STREET
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City | BALTIMORE
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State | MD
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Zip | 21230-3850
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Country | US
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Telephone | 443-869-5641
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Fax | 443-869-5642
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Provider Business Mailing Address
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Address Line | 724 A LIGHT STREET
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City | BALTIMORE
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State | MD
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Zip | 21230-3850
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Country | US
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Telephone | 443-869-5641
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Fax | 443-869-5642
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RALPH ELI LEBLANC
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Credential | MD
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Telephone | 304-813-8332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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