Provider Demographics
NPI:1225662828
Name:FEDERAL HILL MEDICAL CENTER
Entity Type:Organization
Organization Name:FEDERAL HILL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:ELI
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-813-8332
Mailing Address - Street 1:724 A LIGHT STREET
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-3850
Mailing Address - Country:US
Mailing Address - Phone:443-869-5641
Mailing Address - Fax:443-869-5642
Practice Address - Street 1:724 A LIGHT STREET
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-3850
Practice Address - Country:US
Practice Address - Phone:443-869-5641
Practice Address - Fax:443-869-5642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty