1699870659 NPI number — MARYLAND PEDIATRIC ORTHOPAEDIC CENTER

Table of content: (NPI 1699870659)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699870659 NPI number — MARYLAND PEDIATRIC ORTHOPAEDIC CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARYLAND PEDIATRIC ORTHOPAEDIC CENTER
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:
1699870659
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 883
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT AIRY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21771-0883
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-829-5860
Provider Business Mailing Address Fax Number:
301-829-5820

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1502 S MAIN ST
Provider Second Line Business Practice Location Address:
#205
Provider Business Practice Location Address City Name:
MOUNT AIRY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21771-5325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-829-5860
Provider Business Practice Location Address Fax Number:
301-829-5820
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ABRAMOWITZ
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
JAY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-829-5860

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D0056901 , 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)





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