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NPI Code Detail

MEDICARE: UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES, PA

MEDICARE: UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0129XVascular Surgery Physician

General Provider Information

NPI Number : 1144184326
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES, PA
Provider Business Mailing Address
First Line : 29 S GREENE ST STE 502
Second Line :
City : BALTIMORE
State : MD
Zip : 21201-1504
Country : US
Telephone Number : 667-214-1734
Fax Number :
Provider Business Practice Location Address
First Line : 3450 OLD WASHINGTON RD STE 202
Second Line :
City : WALDORF
State : MD
Zip : 20602-3250
Country : US
Telephone Number : 667-214-1718
Fax Number : 410-328-5147
Authorized Official
Title or Position : OFFICE MANAGER
Name : VANENIA CROWDER
Credential :
Telephone Number : 667-214-1734
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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Directions to “UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES, PA ” Practice Location

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