MEDICARE: BALTIMORE VAMC

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
1	261QV0200X	VA Clinic/Center

General Provider Information

NPI Number	:	1811236060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALTIMORE VAMC

Provider Business Mailing Address
First Line	:	PO BOX 89411
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-6411
Country	:	US
Telephone Number	:	828-257-2333
Fax Number	:

Provider Business Practice Location Address
First Line	:	2479 5TH ST
Second Line	:	STE 5138
City	:	FORT MEADE
State	:	MD
Zip	:	20755-9998
Country	:	US
Telephone Number	:	828-257-2333
Fax Number	:

Authorized Official
Title or Position	:	NPI TEAM MEMBER
Name	:	MS. ERIN POTTER
Credential	:
Telephone Number	:	202-382-2579

Provider Enumeration Date	:	02/07/2013
Last Update Date	:	06/01/2023

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