1457433591 NPI number — WARREN H MACLEOD C R N A PA

Table of content: (NPI 1457433591)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457433591 NPI number — WARREN H MACLEOD C R N A PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WARREN H MACLEOD C R N A PA
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:
1457433591
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 DULANEY VALLEY RD
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21204-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-583-1000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 DULANEY VALLEY RD
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-583-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ASSOCIATES
Authorized Official First Name:
DULANEY
Authorized Official Middle Name:
ANESTHESIA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
410-583-1000

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  R051112 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 417274-02 . This is a "BC/BS OF MD BILLING #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 213-52-9270 . This is a "TRICARE BILLING #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 235741 . This is a "KAISER BILLING #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: G9270001 . This is a "BS FEDERAL BILLING #" identifier , issued by the state of ( MH ) . This identifiers is of the category "OTHER".
  • Identifier: 536421300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 430022172 . This is a "MEDICARE RR BILLING #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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