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General NPI Number Information
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NPI Number | 1720163876
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Entity Type | Organization
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Legal Business Name | OBSTETRICAL AND GYNECOLOGICAL ASSOC OF THE UNIVERSITY OF MARYLAND PA
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 419 W REDWOOD ST SUITE 500
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City | BALTIMORE
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State | MD
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Zip | 21201-1751
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Country | US
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Telephone | 410-320-6640
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Fax | 410-328-3379
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Provider Business Mailing Address
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Address Line | 110 SOUTH PACA ST SUITE 6N300
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City | BALTIMORE
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State | MD
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Zip | 21201-1751
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Country | US
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Telephone | 410-328-0253
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Fax | 410-328-3379
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Authorized Official
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Title or Position | DIRECTOR PRFOESSIONAL FEES
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Name | RICK EUGENE BRINEGAR
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Credential |
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Telephone | 410-328-0353
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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 | 723
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | AFP 723
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License Number State | MD
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