Provider Demographics
NPI:1649292699
Name:UNIVERSITY OF MARYLAND PSYCHIATRY ASSOCIATES, PA
Entity type:Organization
Organization Name:UNIVERSITY OF MARYLAND PSYCHIATRY ASSOCIATES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIR
Authorized Official - Prefix:MR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:RACHBEISEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-428-0552
Mailing Address - Street 1:PO BOX 64515
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4515
Mailing Address - Country:US
Mailing Address - Phone:410-328-2539
Mailing Address - Fax:410-328-8552
Practice Address - Street 1:701 W PRATT ST FL 4
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1023
Practice Address - Country:US
Practice Address - Phone:410-328-5881
Practice Address - Fax:717-428-0518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD783091200Medicaid
MDH705Medicare ID - Type Unspecified