Organization
NORTHWEST HOSPITAL CENTER, INC
Active
Parent organization
NORTHWEST HOSPITAL CENTER, INC
Other names
Northwest Cardiology
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST HOSPITAL CENTER, INC
Authorized official
MR. DAVID MCCORMICK (AVP)
(410) 701-4618
Entity
Organization
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Mailing address
5401 OLD COURT RD, ATTN: CREDENTIALING, RANDALLSTOWN, MD 21133-5103
(410) 601-5524
(410) 601-8946
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
03-004
MD
363A00000X
Physician Assistant
03-004
MD
363L00000X
Nurse Practitioner
03-004
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN6601
R/R MEDICARE GROUP #
MD
Enumeration date
09/15/2006
Last updated
10/20/2021
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