Organization
UNIVERSITY CARE
Active
Organization
UNIVERSITY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT SMITH (SR. VICE PRESIDENT)
(410) 328-1184
Entity
Organization
Contact information
Practice address
4538 EDMONDSON AVE, BALTIMORE, MD 21229-1506
(410) 328-2273
(301) 631-1002
Mailing address
PO BOX 64888, BALTIMORE, MD 21264-4888
(410) 328-2273
(301) 631-1002
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400506600
—
MD
Enumeration date
03/30/2009
Last updated
03/30/2009
Update your record
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