Organization
BALTIMORE EMERGENCY SERVICES II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE DAUCHERT (CEO/PRESIDENT)
(919) 768-4392
Entity
Organization
Contact information
Practice address
900 CATON AVE, BALTIMORE, MD 21229-5201
(410) 368-6000
(904) 805-1302
Mailing address
PO BOX 827426, PHILADELPHIA, PA 19182-7426
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
531225
PRIME HLTH MEDICAID
MD
01
—
CJ6193
RAIL ROAD MEDICARE
MD
01
—
J953
DC BLUE CROSS
MD
01
—
LR16BH
BLUE CROSS & BLUE SHIELD
MD
Enumeration date
05/03/2006
Last updated
04/20/2008
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