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General NPI Number Information
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NPI Number | 1851622401
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Entity Type | Organization
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Legal Business Name | US COAST GUARD YARD - HSWL CLINIC
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 2401 HAWKINS POINT RD BLDG 28B
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City | BALTIMORE
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State | MD
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Zip | 21226
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Country | US
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Telephone | 410-626-7506
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Fax | 410-626-7868
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Provider Business Mailing Address
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Address Line | 2401 HAWKINS POINT RD BLDG 28B
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City | BALTIMORE
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State | MD
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Zip | 21226
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Country | US
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Telephone | 410-626-7506
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Fax | 410-626-7868
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Authorized Official
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Title or Position | HSC
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Name | HAROLD E. SCHOFIELD
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Credential |
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Telephone | 410-636-7506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1100X
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Taxonomy Name | Military/U.S. Coast Guard Outpatient Clinic/Center
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License Number |
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License Number State |
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