Provider Demographics
NPI:1700368024
Name:UNIVERSITY OF MARYLAND FAMILY MEDICINE BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:UNIVERSITY OF MARYLAND FAMILY MEDICINE BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOC DIR, PAYER OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-214-1069
Mailing Address - Street 1:250 W PRATT ST STE 900
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-6808
Mailing Address - Country:US
Mailing Address - Phone:667-214-1069
Mailing Address - Fax:
Practice Address - Street 1:29 S PACA ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1771
Practice Address - Country:US
Practice Address - Phone:667-214-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF MARYLAND FAMILY MEDICINE ASSOCIATES, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty