Provider Demographics
NPI:1568698868
Name:UNIVERSITY OF MARYLAND ANESTHESIOLOGY ASSOCIATES P.A.
Entity Type:Organization
Organization Name:UNIVERSITY OF MARYLAND ANESTHESIOLOGY ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PROFESSIONAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAYHART
Authorized Official - Suffix:
Authorized Official - Credentials:CMPE,CPC
Authorized Official - Phone:410-328-6331
Mailing Address - Street 1:110 S PACA ST FL 6
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1645
Mailing Address - Country:US
Mailing Address - Phone:410-328-6331
Mailing Address - Fax:
Practice Address - Street 1:22 S GREENE ST # S11C
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-6120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022565207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty