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General NPI Number Information
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NPI Number | 1750244232
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES, PA
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 419 W REDWOOD ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1734
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Country | US
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Telephone | 667-214-1718
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Fax | 410-328-5147
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Provider Business Mailing Address
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Address Line | 29 S GREENE ST STE 502
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City | BALTIMORE
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State | MD
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Zip | 21201-1504
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Country | US
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Telephone | 667-214-1734
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Fax | 410-706-6976
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | VANENIA CROWDER
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Credential |
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Telephone | 667-214-1734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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