Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glen Burnie Endoscopy Center, LLC

Organization Surgery Physician · NPI 1871424085

Glen Burnie Endoscopy Center, LLC is a Surgery Physician in Glen Burnie, Maryland. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4 Mountain Rd
Glen Burnie, MD 21060-7974
Phone: (410) 659-2963
Fax: (410) 332-9789
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X
Surgical Physician Assistant Taxonomy 363AS0400X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1871424085
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Justin Deibel — Executive Vice President/Cfo · (410) 659-2905
NPI enumeratedMay 27, 2026
Last updated in NPPESMay 27, 2026
Certification dateMay 27, 2026
Mailing address301 St Paul Place, Medical Staff Office, Baltimore, MD 21202-2102

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