Provider Demographics
NPI:1407682503
Name:MT. WASHINGTON PEDIATRIC HOSPITAL INC.
Entity type:Organization
Organization Name:MT. WASHINGTON PEDIATRIC HOSPITAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:DEBORAH
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-578-5163
Mailing Address - Street 1:1708 W ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4545
Mailing Address - Country:US
Mailing Address - Phone:410-578-8600
Mailing Address - Fax:
Practice Address - Street 1:901 HARRY S TRUMAN DR N FL 8
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5477
Practice Address - Country:US
Practice Address - Phone:410-578-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MT. WASHINGTON PEDIATRIC HOSPITAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-13
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty