=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871437293
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNIVERSITY OF MARYLAND SURGCIAL ASSOC PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2026
-----------------------------------------------------
Last Update Date | 04/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14999 HEALTH CENTER DR
-----------------------------------------------------
City | BOWIE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20716-1074
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 667-214-1718
-----------------------------------------------------
Fax | 410-706-6976
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 64226
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21264-4226
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 667-214-1718
-----------------------------------------------------
Fax | 410-706-6976
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | VANENIA CROWDER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 667-214-1734
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 204F00000X
-----------------------------------------------------
Taxonomy Name | Transplant Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------