Organization
ST. PAUL PLACE SPECIALISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DEIBEL (EXECUTIVE VICE PRESIDENT & CFO)
(410) 659-2905
Entity
Organization
Contact information
Practice address
301 ST. PAUL PLACE, LOBBY LEVEL, BALTIMORE, MD 21202-2102
(410) 539-2227
(410) 539-2240
Mailing address
PO BOX 824173, PHILADELPHIA, PA 19182-4173
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F730
BLUECHOICE
MD
01
—
KBM 7
BC / BS OF MD
MD
Enumeration date
05/26/2006
Last updated
12/18/2024
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