Basic Information
| Provider Information | |||||||||
| NPI: | 1306164025 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC. | ||||||||
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| OtherOrganizationName: | BWMC OB/GYN ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7556 TEAGUE RD | ||||||||
| Address2: | SUITE 430 | ||||||||
| City: | HANOVER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210761200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105538260 | ||||||||
| FaxNumber: | 4105538261 | ||||||||
| Practice Location | |||||||||
| Address1: | 7556 TEAGUE RD | ||||||||
| Address2: | SUITE 430 | ||||||||
| City: | HANOVER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210761200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105538260 | ||||||||
| FaxNumber: | 4105538261 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2010 | ||||||||
| LastUpdateDate: | 05/05/2010 | ||||||||
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| AuthorizedOfficialLastName: | PAESCH | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | L. | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4107874879 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.