Organization
DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONIA ROSS (BILLING MANAGER)
(410) 887-0684
Entity
Organization
Contact information
Practice address
1811 WOODLAWN DR, BALTIMORE, MD 21207-4043
(410) 887-1332
Mailing address
6401 YORK RD, BALTIMORE, MD 21212-2152
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
R135730
MD
Other
Enumeration date
12/31/2013
Last updated
07/08/2025
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