# ST. PAUL PLACE SPECIALISTS , INC.

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

## Provider details

- **NPI number:** 1700199783
- **Authorized official:** JUSTIN DEIBEL (EXECUTIVE VICE PRESIDENT & CFO)
- **Authorized official phone:** (410) 659-2905

## Contact information

- **Practice address:** 3501 ST. PAUL STREET, SUITE 143, BALTIMORE, MD 21218
- **Practice address phone:** (410) 235-0506
- **Practice address fax:** (410) 467-3159
- **Mailing address:** PO BOX 824173, PHILADELPHIA, PA 19182-4173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | — | NULL | Yes |
| 367A00000X | Advanced Practice Midwife | — | — | Yes |

## Other

- **Enumeration date:** 07/20/2010
- **Last updated:** 12/18/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 165 L | MEDICARE, ID-TYPE UNSPECIFIED | MD |
| 01 | — | 9754 | BLUE CHOICE | MD |
| 01 | — | LT35 | BC/BS OF MARYLAND | — |