1467316547 NPI number — UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES, PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467316547 NPI number — UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467316547
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29 S GREENE ST STE 502
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21201-1504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
667-214-1734
Provider Business Mailing Address Fax Number:
410-706-6976

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3450 OLD WASHINGTON RD STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WALDORF
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20602-3250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
667-214-1718
Provider Business Practice Location Address Fax Number:
410-328-5147
Provider Enumeration Date:
12/12/2025

Additional Information

Authorized Official

Authorized Official Last Name:
CROWDER
Authorized Official First Name:
VANENIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
667-214-1734

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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