Provider Demographics
NPI:1053531376
Name:STATE OF MARYLAND
Entity type:Organization
Organization Name:STATE OF MARYLAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWERTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-360-2010
Mailing Address - Street 1:101 CLARKE PL
Mailing Address - Street 2:PO BOX 250
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21705-0250
Mailing Address - Country:US
Mailing Address - Phone:301-360-2004
Mailing Address - Fax:
Practice Address - Street 1:101 CLARKE PL
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6529
Practice Address - Country:US
Practice Address - Phone:301-360-2004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)