1205854767 NPI number — GREATER METROPOLITAN ORTHOPAEDICS

Table of content: (NPI 1205854767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205854767 NPI number — GREATER METROPOLITAN ORTHOPAEDICS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREATER METROPOLITAN ORTHOPAEDICS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205854767
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8926 WOODYARD RD
Provider Second Line Business Mailing Address:
SUITE 701
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20735-4220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-856-1682
Provider Business Mailing Address Fax Number:
301-856-0964

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8926 WOODYARD RD
Provider Second Line Business Practice Location Address:
SUITE 701
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20735-4220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-856-1682
Provider Business Practice Location Address Fax Number:
301-856-0964
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SABLOFF
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
301-856-1682

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207XS0117X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2081P2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2491418 . This is a "AETNA GROUP PROVIDER # VIRGINIA LOCATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1205140639 . This is a "LORTON VIRGINIA LOCATION NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1801102504 . This is a "WALDORF MARYLAND LOCATION NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2803674 . This is a "AETNA GROUP PROVIDER # WALDORF LOCATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: S176 . This is a "BCBS MD GRP PROVIDER#" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1194039511 . This is a "SPRINGFIELD VIRGINIA LOCATION NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 145530100 . This is a "DEPARTMENT OF LABOR PROV#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1548576242 . This is a "ALEXANDRIA VIRGINIA LOCATION NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21D1105636 . This is a "CLIA NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: CI2264 . This is a "RAILROAD MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0254450001 . This is a "MEDICARE NSC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0455415 . This is a "AETNA GROUP PROVIDER # CLINTON LOCATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: DG8302 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 4695 . This is a "BCBS NCA GRP PROV#" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 712403 . This is a "UNITED HEALTH CARE/MAMSI GROUP PROVIDER#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1184930885 . This is a "CLINTON MARYLAND LOCATION NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1942514450 . This is a "MOUNT VERNON VIRGINIA LOCATION NPI" identifier . This identifiers is of the category "OTHER".




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