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General NPI Number Information
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NPI Number | 1659964344
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Entity Type | Organization
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Legal Business Name | STATE OF MARLYAND
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Dates
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Enumeration Date | 02/15/2021
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Last Update Date | 02/15/2021
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Provider Practice Location Address
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Address Line | 1800 WASHINGTON BOULEVARD
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City | BALTIMORE
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State | MD
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Zip | 21230-1718
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Country | US
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Telephone | 410-537-3138
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 WASHINGTON BOULEVARD
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City | BALTIMORE
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State | MD
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Zip | 21230-1718
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Country | US
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Telephone | 410-537-3138
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, OPERATIONAL SERVICES ADMI
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Name | MR. THOMAS JOSEPH FRENCH JR.
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Credential |
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Telephone | 410-537-3138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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