Organization
SAINT 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
227 SAINT PAUL PL, 6TH FLOOR, BALTIMORE, MD 21202-2001
(410) 332-9700
(410) 545-4330
Mailing address
PO BOX 824173, PHILADELPHIA, PA 19182-4173
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9754
BLUE CHOICE
MD
01
—
KG 65 ST
BC / BS OF MD
MD
01
—
S186
BLUECHOICE
MD
Enumeration date
05/26/2006
Last updated
12/18/2024
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