Provider Demographics
NPI:1568806933
Name:BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC
Entity Type:Organization
Organization Name:BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC
Other - Org Name:BWMC SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAESCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-787-4879
Mailing Address - Street 1:305 HOSPITAL DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5805
Mailing Address - Country:US
Mailing Address - Phone:410-553-8150
Mailing Address - Fax:410-553-8135
Practice Address - Street 1:305 HOSPITAL DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5805
Practice Address - Country:US
Practice Address - Phone:410-553-8150
Practice Address - Fax:410-553-8135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty