Provider Demographics
NPI:1851318943
Name:BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC.
Entity Type:Organization
Organization Name:BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC.
Other - Org Name:
Other - Org Type:
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 1:8601 VETERANS HWY
Mailing Address - Street 2:204
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1547
Mailing Address - Country:US
Mailing Address - Phone:410-729-0424
Mailing Address - Fax:410-729-0492
Practice Address - Street 1:8601 VETERANS HWY
Practice Address - Street 2:204
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-1547
Practice Address - Country:US
Practice Address - Phone:410-729-0424
Practice Address - Fax:410-729-0492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD549631400Medicaid
MDCC0691OtherMEDICARE RAIL ROAD
MD549631400Medicaid
CC0691 RAIL ROADMedicare PIN