Organization
DRS KIME GIPSON AND SUTULA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MARY MCDONALD (DIRECTOR OF BILLING)
(410) 350-2193
Entity
Organization
Contact information
Practice address
3001 S HANOVER ST, NA114, BALTIMORE, MD 21225-1233
(410) 350-2112
Mailing address
3001 S HANOVER ST, NA114, BALTIMORE, MD 21225-1233
(410) 350-2112
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
—
—
207ZC0006X
Clinical Pathology Physician
—
—
207ZC0500X
Cytopathology Physician
Primary
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZF0201X
Forensic Pathology Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZI0100X
Immunopathology Physician
—
—
207ZM0300X
Medical Microbiology Physician
—
—
207ZN0500X
Neuropathology Physician
—
—
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
207ZP0104X
Chemical Pathology Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
207ZP0213X
Pediatric Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W299
MEDICARE
MD
Enumeration date
11/30/2007
Last updated
11/30/2007
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