Provider Demographics
NPI:1013135599
Name:JEAN ANN BIALAS WOMENS MEDICAL
Entity Type:Organization
Organization Name:JEAN ANN BIALAS WOMENS MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BIALAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-759-2900
Mailing Address - Street 1:600 MEMORIAL AVE
Mailing Address - Street 2:SUITE 303 WOMENS MEDICAL
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3765
Mailing Address - Country:US
Mailing Address - Phone:410-872-9188
Mailing Address - Fax:410-872-9169
Practice Address - Street 1:600 MEMORIAL AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-3765
Practice Address - Country:US
Practice Address - Phone:301-759-2900
Practice Address - Fax:301-759-4850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207VG0400X, 207VM0101X, 207VX0000X
MDD0051177207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1309902OtherBCBS
DCG725OtherBCBS
MD1B02JLOtherBCBS
MD690404100Medicaid
MD690404100Medicaid
PA1309902OtherBCBS