Provider Demographics
NPI:1144362112
Name:BALTIMORE PULMONARY & CRITICAL CARE, PA
Entity type:Organization
Organization Name:BALTIMORE PULMONARY & CRITICAL CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SURJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:JULKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-669-1393
Mailing Address - Street 1:821 N. EUTAW STREET
Mailing Address - Street 2:SUITE 407
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-6304
Mailing Address - Country:US
Mailing Address - Phone:410-669-1393
Mailing Address - Fax:443-524-0749
Practice Address - Street 1:821 N. EUTAW STREET
Practice Address - Street 2:SUITE 407
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-6304
Practice Address - Country:US
Practice Address - Phone:410-669-1393
Practice Address - Fax:443-524-0749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD066250000Medicaid
MD476LMedicare PIN