1629070883 NPI number — DRS. HAHN AND PADGETT

Table of content: (NPI 1629070883)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629070883 NPI number — DRS. HAHN AND PADGETT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. HAHN AND PADGETT
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:
1629070883
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5601 LOCH RAVEN BLVD
Provider Second Line Business Mailing Address:
STE 103
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21239-2905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-532-3991
Provider Business Mailing Address Fax Number:
410-532-3998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5601 LOCH RAVEN BLVD
Provider Second Line Business Practice Location Address:
STE 103
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21239-2905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-532-3991
Provider Business Practice Location Address Fax Number:
410-532-3998
Provider Enumeration Date:
06/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HAHN
Authorized Official First Name:
DAVIS
Authorized Official Middle Name:
MILFORD
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
410-532-3991

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D0020396 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: D0015546 , 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: CF4874 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 200461500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: LY92HA . This is a "CAREFIRST OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: T591 . This is a "CAREFIRST NATIONAL CAPITAL AREA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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