Provider Demographics
NPI:1881226934
Name:UNIVERSITY OF MARYLAND ONCOLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:UNIVERSITY OF MARYLAND ONCOLOGY ASSOCIATES, PA
Other - Org Name:CANCER CENTER MOLECULAR GENETIC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF ONCOLOGY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAIDAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-328-2632
Mailing Address - Street 1:250 W PRATT ST STE 500
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-6804
Mailing Address - Country:US
Mailing Address - Phone:667-214-1069
Mailing Address - Fax:
Practice Address - Street 1:655 W BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1509
Practice Address - Country:US
Practice Address - Phone:410-706-3339
Practice Address - Fax:410-328-3510
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF MARYLAND ONCOLOGY ASSOCIATES, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-06
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty