1659325868 NPI number — DR. SHELDON LESLIE MARGULIES II M.D.

Table of content: HANNAH J FORMELLA (NPI 1134478803)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659325868 NPI number — DR. SHELDON LESLIE MARGULIES II M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARGULIES
Provider First Name:
SHELDON
Provider Middle Name:
LESLIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
II
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1659325868
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:
705 KERSEY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20902-3054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-754-0888
Provider Business Mailing Address Fax Number:
301-593-2183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705 KERSEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20902-3054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-754-0888
Provider Business Practice Location Address Fax Number:
301-593-2183
Provider Enumeration Date:
05/20/2006

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: 174400000X , with the licence number:  D0028087 , 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: 222540600 . This is a "DEPT. OF LABOR" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 543850 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 036857800 . This is a "MEDICAL ASSISTANCE" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 5761 SL . This is a "BCBS MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 6605 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 0500539 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 277989 . This is a "ALLIANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 06788 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 277989 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 000793945 . This is a "BLUE CROSS BLUE SHEILD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25627 . This is a "IWIF" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 339221001 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 53011 . This is a "FIRST HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 118468 . This is a "TRIGON BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 6374326-0022 . This is a "CIGNA PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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