Provider Demographics
NPI:1124016696
Name:BALTIMORE WASHINGTON MEDICAL CENTER INC.
Entity type:Organization
Organization Name:BALTIMORE WASHINGTON MEDICAL CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRETT
Authorized Official - Last Name:MCCONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-787-4529
Mailing Address - Street 1:301 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5803
Mailing Address - Country:US
Mailing Address - Phone:410-787-4000
Mailing Address - Fax:
Practice Address - Street 1:301 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5803
Practice Address - Country:US
Practice Address - Phone:410-787-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
145243800OtherDEPT.OF LABOR
57359101OtherBLUE CROSS BLUE SHIELD
0062413OtherMAIL HANDLERS
396674OtherFEDERAL BLACK LUNG
DE0000413405Medicaid
234175OtherMAMSI
45749OtherAMERIGROUP
52095OtherKAISER PERMANENTE
73288OtherHUMANA
MD000445600Medicaid
07539OtherAETNA
VA0175542000Medicaid
5000081OtherUHC
HE4OtherBLUE CROSS BLUE SHIELD
23222OtherAETNA US HEALTHCARE
234175OtherMAMSI
396674OtherFEDERAL BLACK LUNG
MDCG7577Medicare PIN
57359101OtherBLUE CROSS BLUE SHIELD
MD000445600Medicaid