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General NPI Number Information
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NPI Number | 1598972259
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Entity Type | Organization
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Legal Business Name | BALTIMORE ONCOLOGY HEMATOLOGY ASSOCIATES LLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 821 N EUTAW ST STE 206
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City | BALTIMORE
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State | MD
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Zip | 21201-6302
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Country | US
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Telephone | 410-246-4450
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Fax | 410-617-8326
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Provider Business Mailing Address
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Address Line | 5118 HOLLY CREEK LN
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1191
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Country | US
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Telephone | 240-338-7472
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAVITA KALRA
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Credential |
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Telephone | 240-338-7472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | BK7654076
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License Number State | MD
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