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General NPI Number Information
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NPI Number | 1801135439
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Entity Type | Organization
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Legal Business Name | GRACE MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 2000 W BALTIMORE ST STE 3200
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City | BALTIMORE
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State | MD
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Zip | 21223-1558
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Country | US
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Telephone | 410-362-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 W BALTIMORE ST # 3200
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City | BALTIMORE
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State | MD
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Zip | 21223-1558
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Country | US
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Telephone | 410-362-3000
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Fax |
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Authorized Official
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Title or Position | VP
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Name | REBECCA A ALTMAN
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Credential |
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Telephone | 443-924-1856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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