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General NPI Number Information
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NPI Number | 1629739503
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Entity Type | Organization
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Legal Business Name | PEDS UROCARE
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 6600 YORK RD STE 112
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City | BALTIMORE
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State | MD
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Zip | 21212-2029
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Country | US
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Telephone | 888-535-2534
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Fax | 304-903-6691
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Provider Business Mailing Address
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Address Line | 8233 TOWNSHIP DR
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5417
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Country | US
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Telephone | 773-531-7461
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Fax |
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Authorized Official
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Title or Position | NP
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Name | DAWN DIAZ SALDANO
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Credential | NP
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Telephone | 773-531-7461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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