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General NPI Number Information
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NPI Number | 1447254172
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Entity Type | Organization
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Legal Business Name | SURGICENTER OF BALTIMORE
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 23 CROSSROADS DRIVE STE 100
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5420
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Country | US
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Telephone | 410-356-0300
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Fax | 410-356-7507
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Provider Business Mailing Address
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Address Line | 23 CROSSROADS DRIVE STE 100
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5420
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Country | US
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Telephone | 410-356-0300
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Fax | 410-356-7507
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Authorized Official
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Title or Position | BILLING COORDINATOR
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Name | STEPHANIE MATTES
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Credential |
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Telephone | 410-356-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | A1045
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License Number State | MD
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