Organization
NORTHWEST HOSPITAL CENTER, INC
Active
Other names
NW Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
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
2084N0400X
Neurology 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
08/08/2006
Last updated
10/20/2021
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