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General NPI Number Information
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NPI Number | 1841468782
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Entity Type | Organization
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Legal Business Name | GARWYN UROLOGICAL CENTER
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 2300 GARRISON BLVD 107 GARWYN UROLOGICAL CENTER
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City | BALTIMORE
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State | MD
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Zip | 21216-2397
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Country | US
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Telephone | 410-566-6665
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Fax | 410-566-1365
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Provider Business Mailing Address
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Address Line | 2300 GARRISON BLVD 107 GARWYN UROLOGICAL CENTER
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City | BALTIMORE
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State | MD
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Zip | 21216-2397
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Country | US
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Telephone | 410-566-6665
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Fax | 410-566-1365
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Authorized Official
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Title or Position | UROLOGIST
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Name | DR. BENJAMIN I OPARA
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Credential | MD
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Telephone | 410-566-6665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | D0022929
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License Number State | MD
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