Provider Demographics
NPI:1073491916
Name:MARYLAND ONCOLOGY HEMATOLOGY
Entity type:Organization
Organization Name:MARYLAND ONCOLOGY HEMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-442-2026
Mailing Address - Street 1:11720 BELTSVILLE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3119
Mailing Address - Country:US
Mailing Address - Phone:240-223-1869
Mailing Address - Fax:
Practice Address - Street 1:6505 BELCREST RD STE 110
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2011
Practice Address - Country:US
Practice Address - Phone:301-779-8800
Practice Address - Fax:202-636-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty