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General NPI Number Information
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NPI Number | 1245380872
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Entity Type | Organization
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Legal Business Name | BALTIMORE VAMC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 5235 KING AVE STE 200
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City | ROSEDALE
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State | MD
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Zip | 21237-4068
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Country | US
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Telephone | 828-257-2333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 89411
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City | CLEVELAND
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State | OH
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Zip | 44101-6411
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Country | US
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Telephone | 828-257-2333
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Fax |
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Authorized Official
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Title or Position | NPI TEAM MEMBER
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Name | ERIN POTTER
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Credential |
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Telephone | 202-382-2579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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