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General NPI Number Information
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NPI Number | 1821261298
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Entity Type | Organization
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Legal Business Name | ENDOSCOPY CENTER OF NORTH BALTLIMORE
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 1220C E JOPPA RD SUITE A508
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City | TOWSON
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State | MD
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Zip | 21286-5814
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Country | US
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Telephone | 410-296-4415
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Fax | 410-296-4417
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Provider Business Mailing Address
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Address Line | 1220C E JOPPA RD SUITE A508
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City | TOWSON
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State | MD
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Zip | 21286-5814
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Country | US
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Telephone | 410-296-4415
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Fax | 410-296-4417
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. NEIL GOLDBERG
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Credential | MD
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Telephone | 410-296-4415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A1385
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License Number State | MD
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