Provider Demographics
NPI:1568287811
Name:EMERGENCY SERVICE ASSOCIATES PA
Entity type:Organization
Organization Name:EMERGENCY SERVICE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PIERRE
Authorized Official - Last Name:DILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-677-6619
Mailing Address - Street 1:PO BOX 69318
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9318
Mailing Address - Country:US
Mailing Address - Phone:443-393-9831
Mailing Address - Fax:
Practice Address - Street 1:9733 HEALTHWAY DR
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1155
Practice Address - Country:US
Practice Address - Phone:410-641-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty