Active NPI
Mercy Medical Center
- Clinical Pathology/Laboratory Medicine Physician
- Baltimore, MD
National Provider Identifier
1710696943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- Legal business name
- MERCY MEDICAL CENTER
- Practice address
- 301 Saint Paul PL
Baltimore, MD 21202-2165 - Phone
- (410) 659-2963
- Fax
- (410) 659-2963
- NPI assigned
- Nov 16, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Justin Deibel
- Title
- Chief Financial Officer
- Phone
- (410) 659-2905
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | Primary |
Addresses
Primary practice location
301 Saint Paul PL
Baltimore, MD 21202-2165
Mailing address
301 St Paul Place
Medical Staff Office
Baltimore, MD 21202
Phone (410) 659-2963
Other names 1
- Mercy Medical Center Laboratory
National Provider Directory
National Provider Directory- Tax ID family
- Mercy Medical Center Inc
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668556800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1668556800000",
"number": "1710696943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 ST PAUL PLACE",
"address_2": "MEDICAL STAFF OFFICE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21202",
"telephone_number": "410-659-2963",
"fax_number": "410-659-2963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 SAINT PAUL PL",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212022165",
"telephone_number": "410-659-2963",
"fax_number": "410-659-2963"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERCY MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-16",
"last_updated": "2022-11-16",
"certification_date": "2022-11-11",
"status": "A",
"authorized_official_last_name": "DEIBEL",
"authorized_official_first_name": "JUSTIN",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "410-659-2905"
},
"taxonomies": [
{
"code": "207ZP0105X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Mercy Medical Center Laboratory",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.