Organization
BALTIMORE CENTER FOR FACIAL PLASTIC SURGERY, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH BAKER CAPONE M.D. (OWNER)
(410) 848-4123
Entity
Organization
Contact information
Practice address
6535 N CHARLES ST, PHYSICIANS PAVILION NORTH, BALTIMORE, MD 21204-5826
(410) 848-4123
(410) 848-4124
Mailing address
6535 N CHARLES ST, PHYSICIANS PAVILION NORTH, BALTIMORE, MD 21204-5826
(410) 848-4123
(410) 848-4124
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
D0060483
MD
208200000X
Plastic Surgery Physician
D0060483
MD
Other
Enumeration date
12/07/2007
Last updated
12/07/2007
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