Organization
THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANA STOUT (VICE PRESIDENT FINANCE)
(443) 444-3841
Entity
Organization
Contact information
Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(443) 444-8000
Mailing address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(443) 444-8000
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219081800
—
MD
01
—
FY01GO
CAREFIRST BC/BS MARYLAND
MD
01
—
W606
CAREFIRST BLUECHOICE DC
MD
Enumeration date
01/22/2009
Last updated
01/22/2009
Update your record
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