Provider Demographics
NPI:1689921611
Name:BSP ASSOCIATES
Entity type:Organization
Organization Name:BSP ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIGGIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH-POPE
Authorized Official - Suffix:
Authorized Official - Credentials:CRBA
Authorized Official - Phone:301-317-0020
Mailing Address - Street 1:707 HAACK PL
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2164
Mailing Address - Country:US
Mailing Address - Phone:301-324-7901
Mailing Address - Fax:
Practice Address - Street 1:707 HAACK PL
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-2164
Practice Address - Country:US
Practice Address - Phone:301-317-0020
Practice Address - Fax:301-317-0028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR109071207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty