Organization
NORTHWEST HOSPITAL CENTER, INC.
Active
Other names
Chronic Disease Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MCCORMICK (AVP)
(410) 701-4618
Entity
Organization
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 701-4434
Mailing address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 701-4434
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211300700
—
MD
Enumeration date
06/19/2017
Last updated
07/21/2022
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