# ST PAUL PLACE SPECIALISTS, INC.

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

## Provider details

- **NPI number:** 1851405187
- **Authorized official:** JUSTIN DEIBEL (EXECUTIVE VICE PRESIDENT & CFO)
- **Authorized official phone:** (410) 659-2905

## Contact information

- **Practice address:** 301 ST PAUL PLACE, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202
- **Practice address phone:** (410) 659-2802
- **Mailing address:** PO BOX 824173, PHILADELPHIA, PA 19182-4173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 08/17/2006
- **Last updated:** 12/18/2024