Provider Demographics
NPI:1275947319
Name:UNIVERSITY OF MARYLAND SCHOOL OF NURSING
Entity Type:Organization
Organization Name:UNIVERSITY OF MARYLAND SCHOOL OF NURSING
Other - Org Name:SEED SCHOOL SCHOOL-BASED HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ANTOL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:410-706-5145
Mailing Address - Street 1:655 W LOMBARD ST
Mailing Address - Street 2:SUITE 425B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1512
Mailing Address - Country:US
Mailing Address - Phone:410-706-5395
Mailing Address - Fax:410-706-0140
Practice Address - Street 1:200 FONT HILL AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2703
Practice Address - Country:US
Practice Address - Phone:410-843-9477
Practice Address - Fax:410-843-9496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health