Organization
SAINT PAUL PLACE SPECIALISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DEIBEL (EXECUTIVE VICE PRESIDENT & CFO)
(410) 659-2905
Entity
Organization
Contact information
Practice address
301 SAINT PAUL PL, BURK BLDG 321, BALTIMORE, MD 21202-2102
(410) 332-9145
(410) 332-9105
Mailing address
PO BOX 64075, BALTIMORE, MD 21264-4075
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S186
BLUECHOICE
MD
01
—
S798
BC / BS OF MD
MD
Enumeration date
06/09/2006
Last updated
12/18/2024
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