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Organization
ST PAUL PLACE SPECIALISTS, INC.
Active
Organization
ST PAUL PLACE SPECIALISTS, INC.
Active
Other names
SPPS Canton Foster Ave
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DEIBEL (EXECUTIVE VICE PRESIDENT/CFO)
(410) 659-2905
Entity
Organization
Contact information
Practice address
2801 FOSTER AVE, BALTIMORE, MD 21224-3865
(410) 332-9000
Mailing address
301 ST PAUL PLACE, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202-2102
(410) 659-2963
(410) 332-9789
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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