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General NPI Number Information
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NPI Number | 1558394411
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MARYLAND PATHOLOGY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 655 W BALTIMORE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1509
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Country | US
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Telephone | 410-706-3026
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 64592
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City | BALTIMORE
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State | MD
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Zip | 21264-4592
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Country | US
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Telephone | 410-328-5514
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Fax | 410-328-0929
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Authorized Official
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Title or Position | CORPORATE DIRECTOR, FPI PROFESSIONA
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Name | SHAVONDA L WILLIAMS
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Credential |
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Telephone | 410-302-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 355
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License Number State | MD
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