Provider Demographics
NPI:1952529398
Name:MARYLAND HEALTH ONE, INC.
Entity Type:Organization
Organization Name:MARYLAND HEALTH ONE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CARIDAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-528-1182
Mailing Address - Street 1:1 E CHASE ST
Mailing Address - Street 2:200
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2526
Mailing Address - Country:US
Mailing Address - Phone:410-528-1182
Mailing Address - Fax:410-528-1185
Practice Address - Street 1:1 E CHASE ST
Practice Address - Street 2:200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2526
Practice Address - Country:US
Practice Address - Phone:410-528-1182
Practice Address - Fax:410-528-1185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD041950OtherUNITED HEALTH CARE
MD67237OtherAMERIGROUP
MD67237OtherAMERIGROUP