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General NPI Number Information
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NPI Number | 1376438903
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MARYLAND ORTHOPAEDIC TRAUMA ASSOCIATES, PA
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 255 HOSPITAL DR STE 207
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City | GLEN BURNIE
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State | MD
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Zip | 21061-5801
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Country | US
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Telephone | 410-448-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 KERNAN DR STE 1154
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City | BALTIMORE
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State | MD
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Zip | 21207-6665
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Country | US
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Telephone | 667-214-2732
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Fax | 667-214-2732
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Authorized Official
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Title or Position | MANAGER
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Name | JOSHUA GODMAN
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Credential |
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Telephone | 667-214-2732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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