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Organization
U M FDSP ASSOCIATES PA
Active
Organization
U M FDSP ASSOCIATES PA
Active
Parent organization
U M FDSP ASSOCIATES PA
Other names
UM Oral Pathology Consultants, Oral Pathology Consultants
Organization subpart
Yes
Provider details
NPI number
Legal business name
U M FDSP ASSOCIATES PA
Authorized official
JOHN ROBERT BASILE (PHYSICIAN)
(410) 706-7937
Entity
Organization
Contact information
Practice address
650 W. BALTIMORE ST., 7-NORTH, BALTIMORE, MD 21201-1586
(410) 706-7936
(410) 706-6115
Mailing address
650 W BALTIMORE ST, BALTIMORE, MD 21201-1510
(410) 706-7936
(410) 706-6115
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
4626
MD
291U00000X
Clinical Medical Laboratory
182
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190003329
RAILROAD MEDICARE
MD
05
—
418538200
—
MD
Enumeration date
10/25/2006
Last updated
04/15/2026
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