Provider Demographics
NPI:1205062767
Name:SINAI HOSPITAL OF BALTIMORE, INC
Entity type:Organization
Organization Name:SINAI HOSPITAL OF BALTIMORE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:B
Authorized Official - Last Name:EFIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-601-7019
Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:CREDENTIALING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-5523
Mailing Address - Fax:410-601-8946
Practice Address - Street 1:21 CROSSROADS DR
Practice Address - Street 2:SUITE 400
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5441
Practice Address - Country:US
Practice Address - Phone:410-998-9100
Practice Address - Fax:410-998-9104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SINAI HOSPITAL OF BALTIMORE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-10
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30-062207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD382301600Medicaid
MDC31152OtherR/R MEDICARE GROUP #
MDC31152OtherR/R MEDICARE GROUP #