Organization
SETON MEDICAL GROUP, INC
Active
Parent organization
ASCENSION HEALTH
Other names
Ascension Saint Agnes Primary Care Canton
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASCENSION HEALTH
Authorized official
MR. WILLIAM B HIGGINBOTHAM (PRESIDENT/CEO)
(667) 234-3162
Entity
Organization
Contact information
Practice address
2801 FOSTER AVENUE, BALTIMORE, MD 21224-3862
(410) 342-0333
Mailing address
2801 FOSTER AVENUE, BALTIMORE, MD 21224-3862
(410) 342-0333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
10/31/2024
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