Organization
ST PAUL PLACE SPECIALISTS, INC.
Active
Other names
SPPS Annapolis 802 Bestgate
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DEIBEL (EXECUTIVE VICE PRESIDENT/CFO)
(410) 659-2905
Entity
Organization
Contact information
Practice address
802 BESTGATE RD, ANNAPOLIS, MD 21401-3024
(410) 332-9000
Mailing address
301 ST PAUL PLACE, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202-2102
(410) 659-2963
(410) 332-9789
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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