1114900313 NPI number — DR. CAROL ANN PARIS M.D.

Table of content: (NPI 1578693636)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114900313 NPI number — DR. CAROL ANN PARIS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARIS
Provider First Name:
CAROL
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1114900313
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2252
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEONARDTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20650-8252
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-997-1494
Provider Business Mailing Address Fax Number:
301-997-1497

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41625 PARK AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
LEONARDTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20650-8252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-997-1494
Provider Business Practice Location Address Fax Number:
301-997-1497
Provider Enumeration Date:
11/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  D0053907 , 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: 048671000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1011932 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 710931172 . This is a "ONE HEALTH PLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 710931172 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 710931172 . This is a "HEALTHNET" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 231008000 . This is a "MAGELLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 366674 . This is a "MDIPA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 710931172 . This is a "PHCS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 201092 . This is a "MANAGED HEALTH NETWORK" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 68611908 . This is a "BC/BS OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 060402 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 366674 . This is a "OPTIMUM CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: M377 . This is a "BC/BS NAT'L CAP AREA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 11862 . This is a "JOHNS HOPKINS HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 366674 . This is a "ALLIANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: PV94571 . This is a "AMERICAN PSYCH SERVICES" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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