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Organization
SURGICENTER OF BALTIMORE
Active
Organization
SURGICENTER OF BALTIMORE
Active
Other names
SurgiCenter of Baltimore
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MATTES (BILLING COORDINATOR)
(410) 356-0300
Entity
Organization
Contact information
Practice address
23 CROSSROADS DRIVE, STE 100, OWINGS MILLS, MD 21117-5420
(410) 356-0300
(410) 356-7507
Mailing address
23 CROSSROADS DRIVE, STE 100, OWINGS MILLS, MD 21117-5420
(410) 356-0300
(410) 356-7507
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1045
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0181741
AETNA
MD
01
—
02LM
BCBS
MD
01
—
055335
JOHNS HOPKINS
MD
01
—
110694
KAISER
MD
01
—
20103019SA
CIGNA
MD
05
—
242321900
—
MD
01
—
25872
MAMSI
MD
01
—
2614116
AETNA
MD
01
—
490001255
MEDICARE RAILROAD
MD
01
—
6800095
UNITED HEALTHCARE
MD
01
—
NE3
CAREFIRST BCBS
MD
Enumeration date
06/10/2005
Last updated
12/19/2024
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