Organization
ST PAUL PLACE SPECIALISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DEIBEL (VICE CHAIR)
(410) 659-2905
Entity
Organization
Contact information
Practice address
301 SAINT PAUL ST, BALTIMORE, MD 21202-2102
(410) 332-9882
(410) 234-2558
Mailing address
PO BOX 64075, BALTIMORE, MD 21264-4075
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
434941500
—
MD
01
—
KU59ST
BC/BS OF MD
—
01
—
S188
BLUE CHOICE
MD
Enumeration date
02/21/2007
Last updated
12/18/2024
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