1972680684 NPI number — CAROL HUBER VOELKEL P.T.

Table of content: CAROL HUBER VOELKEL P.T. (NPI 1972680684)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972680684 NPI number — CAROL HUBER VOELKEL P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VOELKEL
Provider First Name:
CAROL
Provider Middle Name:
HUBER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUBER
Provider Other First Name:
CAROL
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1972680684
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13141 GARRETT HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21550-1164
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-334-5220
Provider Business Mailing Address Fax Number:
301-334-6277

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13141 GARRETT HIGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-334-5220
Provider Business Practice Location Address Fax Number:
301-334-6277
Provider Enumeration Date:
11/01/2006

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: 225100000X , with the licence number:  15477 , 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: 11936 . This is a "PRIORITY PARTNERS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 288979 . This is a "ALLIANCE/MD.IPA/OPTIMUM C" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: E273 0004 . This is a "GHMSI & BCBS FEDERAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 15477 . This is a "LICENSE #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 60907701 . This is a "CAREFIRST BBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7305056000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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