1184813792 NPI number — GEH MEDICAL ASSOCIATES, PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184813792 NPI number — GEH MEDICAL ASSOCIATES, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEH MEDICAL ASSOCIATES, 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:
6
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:
1184813792
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1280
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLICOTT CITY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21041-1280
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 ARMORY PL
Provider Second Line Business Practice Location Address:
SUITE 3G
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201-4603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-225-8620
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GEH
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
N
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
410-225-8620

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  D0053987 , 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: 04-04411 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: LW11GE . This is a "CAREFIRST BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2745223 . This is a "AETNA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2783 . This is a "ELDERHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: FO81 . This is a "CAREFIRST BLUE CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 007201000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 022803 . This is a "PRIORITY PARTNERS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 298110 . This is a "MAMSI HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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