Organization
GATEWAY MARYLAND, INC
Active
Other names
CLINICAL
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN STAUDER (AUTHORIZED OFFICIAL)
(410) 318-6780
Entity
Organization
Contact information
Practice address
5900 METRO DR, BALTIMORE, MD 21215-3207
(410) 318-6780
(410) 318-6759
Mailing address
5900 METRO DR, BALTIMORE, MD 21215-3207
(410) 318-6780
(410) 318-6759
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
31008536
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157705100
—
MD
Enumeration date
04/17/2007
Last updated
09/12/2024
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