Organization
U M FDSP ASSOCIATES PA
Active
Parent organization
U M FDSP ASSOCIATES PA
Other names
UM Oral Pathology Consultants, Oral Pathology Consultants
Organization subpart
Yes
Provider details
NPI number
Legal business name
U M FDSP ASSOCIATES PA
Authorized official
JOHN ROBERT BASILE (PHYSICIAN)
(410) 706-7937
Entity
Organization
Contact information
Practice address
650 W. BALTIMORE ST., 7-NORTH, BALTIMORE, MD 21201-1586
(410) 706-7936
(410) 706-6115
Mailing address
650 W BALTIMORE ST, BALTIMORE, MD 21201-1510
(410) 706-7936
(410) 706-6115
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
4626
MD
291U00000X
Clinical Medical Laboratory
182
MD
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190003329
RAILROAD MEDICARE
MD
05
—
418538200
—
MD
Enumeration date
10/25/2006
Last updated
04/15/2026
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