Organization
DVA HEALTHCARE OF MARYLAND LLC
Active
Other names
Bel Air Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2225 OLD EMMORTON RD, STE 105, BEL AIR, MD 21015-6122
(410) 515-2078
(410) 515-3425
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2594
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007727620007
—
PA
05
—
523503100
—
MD
Enumeration date
03/23/2006
Last updated
12/16/2025
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