Organization
BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC
Active
Other names
BWMC Spine
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA L PAESCH (DIRECTOR)
(410) 787-4879
Entity
Organization
Contact information
Practice address
305 HOSPITAL DR, SUITE 303, GLEN BURNIE, MD 21061-5805
(410) 553-8290
(410) 553-8288
Mailing address
PO BOX 62544, BALTIMORE, MD 21264-2544
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPD3BW
CAREFIRST BLUE CROSS BLUE SHIELD
MD
01
—
W763
CARE FIRST BLUE CROSS BLUE SHIELD
—
Enumeration date
08/09/2010
Last updated
10/28/2010
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