# ST PAUL PLACE SPECIALISTS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SPPS Ellicott City
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376418632
- **Authorized official:** JUSTIN DEIBEL (EXECUTIVE VICE PRESIDENT/CFO)
- **Authorized official phone:** (410) 659-2905

## Contact information

- **Practice address:** 3290 N RIDGE RD STE 220, ELLICOTT CITY, MD 21043-3657
- **Practice address phone:** (410) 332-9000
- **Mailing address:** 301 ST PAUL PLACE, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202-2102
- **Mailing address phone:** (410) 659-2963
- **Mailing address fax:** (410) 332-9789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 207RR0500X | Rheumatology Physician | — | NULL | — |
| 207RR0500X | Rheumatology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | Yes |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/07/2025
- **Last updated:** 10/07/2025