Provider Demographics
NPI:1225463821
Name:GREATER BALTIMORE PLASTIC AND HAND SURGERY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:GREATER BALTIMORE PLASTIC AND HAND SURGERY ASSOCIATES, LLC
Other - Org Name:NORTH CHARLES PLASTIC AND HAND SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-895-4843
Mailing Address - Street 1:6569 N CHARLES ST
Mailing Address - Street 2:SUITE 706
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6831
Mailing Address - Country:US
Mailing Address - Phone:443-895-4843
Mailing Address - Fax:443-895-4845
Practice Address - Street 1:6569 N CHARLES ST
Practice Address - Street 2:SUITE 706
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6831
Practice Address - Country:US
Practice Address - Phone:443-895-4843
Practice Address - Fax:443-895-4845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00764592086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty