Organization
GLEN BURNIE ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DEIBEL DEIBEL (EXECUTIVE VICE PRESIDENT/CFO)
(410) 659-2905
Entity
Organization
Contact information
Practice address
4 MOUNTAIN RD, GLEN BURNIE, MD 21060-7974
(410) 659-2963
(410) 332-9789
Mailing address
301 ST PAUL PLACE, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202-2102
(410) 659-2963
(410) 332-9789
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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