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UPMC WESTERN MARYLAND CORPORATION

Clinical Neuropsychologist

Cumberland, Maryland

Provider NPI: 1285779884

Organization Information:
Organization Name:  UPMC WESTERN MARYLAND CORPORATION
Organization is Subpart
Authorized Official:  MICHELE  MARTZ  SR. VP CFO  240-9647376

Practice Location:
12502 WILLOWBROOK RD SUITE 380 CUMBERLAND, MD 21502 US
Tel: 240-964-8585  Fax: 240-964-8586

Business Mailing Address:
12502 WILLOWBROOK RD SUITE 380 CUMBERLAND, MD 21502 US
Tel: 240-964-8585  Fax: 240-964-8586

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YP2500XBehavioral Health & Social Service Providers
Counselor
Professional
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MD
N103T00000XBehavioral Health & Social Service Providers
Psychologist
MD
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
MD
Y2084P0800XPhysicians
Psychiatry & Neurology
MD

Other Provider Identifiers:

IssuerNumberStateType
CAREFIRST BC BSKN31MD01
BLUE CHOICEM093DC01
RAILROAD MEDICAREC10132 CE7390MD01
407340100MD05
653131800MD05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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