BALTIMORE ENDOSCOPY ASC LLC NPI 1043282775

NPI Information

NPI: 1043282775
Provider Name: BALTIMORE ENDOSCOPY ASC LLC

Doing Business As: GASTROINTESTINAL DIAGNOSTIC CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
4660 WILKENS AVE
SUITE 301
BALTIMORE, MD
ZIP 21229
Phone: (410) 242-3636
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BALTIMORE ENDOSCOPY ASC LLC is an ambulatory surgical clinic center in Baltimore, MD. BALTIMORE ENDOSCOPY ASC LLC NPI is 1043282775. The provider is registered as an organization entity type.
The provider Is Doing Business As Gastrointestinal Diagnostic Center.

The provider's business location address is:

4660 WILKENS AVE
SUITE 301
BALTIMORE, MD
ZIP 21229-848
Phone: (410) 242-3636
Fax: (410) 242-4404

The provider's authorized official is Jeffrey Snodgrass .
The authorized official title is President and has the following contact phone number (615) 665-1283.

The CLIA number assigned to this NPI record is 21D0944684 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2006 and was last updated on 8/24/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	A1160	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0110027	MEDICAID	MARYLAND
2	521911074001	OTHER	MARYLAND	SIERRA MILITARY HEALTHCAR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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