Basic Information
| Provider Information | |||||||||
| NPI: | 1164771721 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST AGNES HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 S CATON AVE | ||||||||
| Address2: | DEPT .OF SURGERY | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103682718 | ||||||||
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| Practice Location | |||||||||
| Address1: | 900 S CATON AVE | ||||||||
| Address2: | DEPT .OF SURGERY | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103682718 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2012 | ||||||||
| LastUpdateDate: | 08/29/2012 | ||||||||
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| AuthorizedOfficialLastName: | BHATT | ||||||||
| AuthorizedOfficialFirstName: | ASTHA | ||||||||
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| AuthorizedOfficialTitleorPosition: | RESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4049931243 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | P28023 | MD | Y | Hospitals | General Acute Care Hospital | Critical Access |
No ID Information.