# BALTIMORE CENTER FOR FACIAL PLASTIC SURGERY, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689857096
- **Authorized official:** DR. RANDOLPH BAKER CAPONE M.D. (OWNER)
- **Authorized official phone:** (410) 848-4123

## Contact information

- **Practice address:** 6535 N CHARLES ST, PHYSICIANS PAVILION NORTH, BALTIMORE, MD 21204-5826
- **Practice address phone:** (410) 848-4123
- **Practice address fax:** (410) 848-4124
- **Mailing address:** 6535 N CHARLES ST, PHYSICIANS PAVILION NORTH, BALTIMORE, MD 21204-5826
- **Mailing address phone:** (410) 848-4123
- **Mailing address fax:** (410) 848-4124

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | D0060483 | MD | Yes |
| 208200000X | Plastic Surgery Physician | D0060483 | MD | — |

## Other

- **Enumeration date:** 12/07/2007
- **Last updated:** 12/07/2007