Provider Demographics
NPI:1740427525
Name:UNION MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:UNION MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. MEDICAL AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-554-2261
Mailing Address - Street 1:200 E 33RD ST
Mailing Address - Street 2:SUITE 501, 33RD STREET P.O.B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-3322
Mailing Address - Country:US
Mailing Address - Phone:410-554-4511
Mailing Address - Fax:410-554-6490
Practice Address - Street 1:200 E 33RD ST
Practice Address - Street 2:SUITE 501, 33RD STREET P.O.B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3322
Practice Address - Country:US
Practice Address - Phone:410-554-4511
Practice Address - Fax:410-554-6490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409150700Medicaid
MD433AUNOtherCAREFIRST BC/BS MARYLAND
MDW645OtherCAREFIRST BLUECHOICE DC
MD433AUNOtherCAREFIRST BC/BS MARYLAND