Organization
NORTHWEST HOSPITAL CENTER, INC
Active
Other names
NW Breast Care Ctr,Hospitalist,PA, SHS Plastics,Surgical House Staff
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MCCORMICK (CFO)
(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
207R00000X
Internal Medicine Physician
03-004
MD
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
03-004
MD
207RH0003X
Hematology & Oncology Physician
—
—
207RP1001X
Pulmonary Disease Physician
03-004
MD
208200000X
Plastic Surgery Physician
03-004
MD
208600000X
Surgery Physician
03-004
MD
208M00000X
Hospitalist Physician
Primary
03-004
MD
363A00000X
Physician Assistant
03-004
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN6601
R/R MEDICARE GROUP #
MD
Enumeration date
09/13/2006
Last updated
10/20/2021
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