Organization
ST PAUL PLACE SPECIALISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DEIBEL (EXECUTIVE VICE PRESIDENT & CFO)
(410) 659-2905
Entity
Organization
Contact information
Practice address
301 ST. PAUL PLACE, POB 411, BALTIMORE, MD 21202-2102
(410) 332-9346
(410) 385-2354
Mailing address
PO BOX 824173, PHILADELPHIA, PA 19182-4173
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
—
MD
207RR0500X
Rheumatology Physician
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KAZ1
BC / BS OF MD
MD
01
—
S186
BLUECHOICE
MD
Enumeration date
06/09/2006
Last updated
12/18/2024
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