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General NPI Number Information
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NPI Number | 1982558904
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Entity Type | Organization
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Legal Business Name | MARYLAND ONCOLOGY HEMATOLOGY
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 112 THOMAS JOHNSON DR STE 250
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City | FREDERICK
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State | MD
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Zip | 21702-4972
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Country | US
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Telephone | 301-695-6777
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Fax | 301-695-4852
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Provider Business Mailing Address
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Address Line | 11720 BELTSVILLE DR STE 300
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City | BELTSVILLE
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State | MD
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Zip | 20705-3119
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Country | US
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Telephone | 240-223-1869
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Fax |
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Authorized Official
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Title or Position | MANAGED CARE DIRECTOR
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Name | KYLE BLACK
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Credential |
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Telephone | 610-442-2026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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