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General NPI Number Information
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NPI Number | 1487461851
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MARYLAND ONCOLOGY ASSOCIATES, PA
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 2200 KERNAN DR
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City | GWYNN OAK
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State | MD
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Zip | 21207-6665
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Country | US
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Telephone | 410-328-8040
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Fax | 410-328-2578
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Provider Business Mailing Address
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Address Line | PO BOX 62602
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City | BALTIMORE
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State | MD
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Zip | 21264-2602
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CORPORATE DIRECTOR
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Name | SHAVONDA L WILLIAMS
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Credential |
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Telephone | 667-214-2507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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