1124016696 NPI number — BALTIMORE WASHINGTON MEDICAL CENTER INC.

Table of content: (NPI 1124016696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124016696 NPI number — BALTIMORE WASHINGTON MEDICAL CENTER INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BALTIMORE WASHINGTON MEDICAL CENTER INC.
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:
6
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:
1124016696
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN BURNIE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21061-5803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-787-4000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLEN BURNIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21061-5803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-787-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MCCONE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
BRETT
Authorized Official Title or Position:
SR VP FINANCE
Authorized Official Telephone Number:
410-787-4529

Provider Taxonomy Codes

  • Taxonomy code: 207RC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363AM0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 145243800 . This is a "DEPT.OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000413405 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 23222 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0175542000 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 07539 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 45749 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000445600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 73288 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: HE4 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5000081 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 57359101 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0062413 . This is a "MAIL HANDLERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 234175 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 396674 . This is a "FEDERAL BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 52095 . This is a "KAISER PERMANENTE" identifier . This identifiers is of the category "OTHER".




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