1114168556 NPI number — ORTHOPEDIC PHYSICIANS OF ANNAPOLIS LLC

Table of content: AIYANA B. MEADOWS PT (NPI 1285818997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114168556 NPI number — ORTHOPEDIC PHYSICIANS OF ANNAPOLIS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC PHYSICIANS OF ANNAPOLIS LLC
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:
ORTHOPEDIC AND SPORTS MEDICINE CENTER
Provider Other Organization Name Type Code:
3
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:
1114168556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 MEDICAL PKWY
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-3742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-268-8862
Provider Business Mailing Address Fax Number:
410-268-0380

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4175 N HANSON CT
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
BOWIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20716-3179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-268-8862
Provider Business Practice Location Address Fax Number:
410-268-0380
Provider Enumeration Date:
03/16/2009

Additional Information

Authorized Official

Authorized Official Last Name:
CHAPUT
Authorized Official First Name:
MARK
Authorized Official Middle Name:
R
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
410-267-5574

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  A2505 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: A2505 , 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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