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Organization
BALTIMORE CENTER FOR FACIAL PLASTIC SURGERY, L.L.C.
Active
Organization
BALTIMORE CENTER FOR FACIAL PLASTIC SURGERY, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH BAKER CAPONE M.D. (OWNER)
(410) 848-4123
Entity
Organization
Contact information
Practice address
6535 N CHARLES ST, PHYSICIANS PAVILION NORTH, BALTIMORE, MD 21204-5826
(410) 848-4123
(410) 848-4124
Mailing address
6535 N CHARLES ST, PHYSICIANS PAVILION NORTH, BALTIMORE, MD 21204-5826
(410) 848-4123
(410) 848-4124
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
D0060483
MD
208200000X
Plastic Surgery Physician
D0060483
MD
Other
Enumeration date
12/07/2007
Last updated
12/07/2007
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