| Um Fdsp Associates, P.a. | |
|
650 W Baltimore St Baltimore MD 21201-1510 | |
| (410) 706-7625 | |
| (410) 706-3028 |
| Full Name | Um Fdsp Associates, P.a. |
|---|---|
| Speciality | Dentist |
| Location | 650 W Baltimore St, Baltimore, Maryland |
| Authorized Official Name and Position | Mark E Sutter (FISCAL BUSINESS MANAGER) |
| Authorized Official Contact | 4107060652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Um Fdsp Associates, P.a. 650 W Baltimore St Room 5201 Baltimore MD 21201-1510 Ph: (410) 706-7625 | Um Fdsp Associates, P.a. 650 W Baltimore St Baltimore MD 21201-1510 Ph: (410) 706-7625 |
| NPI Number | 1104909449 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 04/01/2021 |
| Medicare PECOS PAC ID | 3375506306 |
|---|---|
| Medicare Enrollment ID | O20041110000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104909449 | NPI | - | NPPES |
| 406017200 | Medicaid | MD | |
| 218445197-0001 | Other | MD | CAREFIRST BCBS FEDERAL |
| 642115-01 | Other | MD | CAREFIRST BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5034 (Maryland) | Primary |
| Provider Name | Timothy F Meiller |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1134283427 PECOS PAC ID: 3274585146 Enrollment ID: I20050218000571 |
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