Organization
EASTERN SHORE UROLOGY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KNUD-HANSEN MD (AUTHORIZED OFFICIAL/OWNER)
(410) 822-5552
Entity
Organization
Contact information
Practice address
6 CAULK LN, EASTON, MD 21601-3854
(410) 822-5552
Mailing address
6 CAULK LN, EASTON, MD 21601-3854
(410) 822-5552
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA6016
RAILROAD MC GROUP #
MD
01
—
E683
BCBS NAT'L CAPITAL GRP#
MD
01
—
K092EA
BCBS OF MD GROUP #
MD
Enumeration date
08/03/2006
Last updated
08/22/2020
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