Iwc Services Maryland LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

IWC SERVICES MARYLAND LLC

Practice address

1801 Wentworth Rd
Baltimore, MD 21234-6128

Phone

(732) 451-4318

NPI assigned

May 6, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane Lusas

Title

Owner

Phone

(732) 451-4318

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1124955869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492C CEDAR LN STE 514",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 WENTWORTH RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212346128",
            "telephone_number": "732-451-4318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IWC SERVICES MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-06",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "LUSAS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-451-4318"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.