1619174885 NPI number — DIANE MARGARETE DARR PA-C

Table of content: DIANE MARGARETE DARR PA-C (NPI 1619174885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619174885 NPI number — DIANE MARGARETE DARR PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DARR
Provider First Name:
DIANE
Provider Middle Name:
MARGARETE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
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:
1619174885
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16111 HARWOOD DR SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FROSTBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21532-3264
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-566-3001
Provider Business Mailing Address Fax Number:
240-566-3003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CORP OHS FREDERICK 490-L PROSPECT BLVD
Provider Second Line Business Practice Location Address:
490-L
Provider Business Practice Location Address City Name:
FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-566-3001
Provider Business Practice Location Address Fax Number:
240-566-3003
Provider Enumeration Date:
06/29/2007

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: 363A00000X , with the licence number:  COOO1130 , 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)





Copyright © 2007-2024 www.npivalidator.com