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General NPI Number Information
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NPI Number | 1790867802
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Entity Type | Organization
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Legal Business Name | VETERANS AFFAIRS MARYLAND HEALTH CARE SYSTEM
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 10 N GREENE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1524
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Country | US
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Telephone | 410-605-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 118 N HOWARD ST APT 601
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City | BALTIMORE
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State | MD
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Zip | 21201-3424
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Country | US
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Telephone | 410-528-8945
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CLINICAL AUDIOLOGY
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Name | DR. CARLA BRANDILYN SPYIES
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Credential | AU.D.
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Telephone | 410-605-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 01116
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License Number State | MD
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