Provider Demographics
NPI:1598332405
Name:PEDS UROCARE
Entity Type:Organization
Organization Name:PEDS UROCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ SALDANO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:773-531-7461
Mailing Address - Street 1:8233 TOWNSHIP DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5417
Mailing Address - Country:US
Mailing Address - Phone:773-531-7461
Mailing Address - Fax:
Practice Address - Street 1:6600 YORK RD
Practice Address - Street 2:SUITE 112
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2028
Practice Address - Country:US
Practice Address - Phone:773-531-7461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty