1982878716 NPI number — MARIE C CHOPPIN, LLC

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 1982878716 NPI number — MARIE C CHOPPIN, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARIE C CHOPPIN, LLC
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:
1982878716
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12600 PENTENVILLE 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:
20904-3525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-625-9102
Provider Business Mailing Address Fax Number:
866-445-3249

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8830 CAMERON CT
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20910-4114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-625-9102
Provider Business Practice Location Address Fax Number:
866-445-3249
Provider Enumeration Date:
04/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CHOPPIN
Authorized Official First Name:
MARIE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-625-9102

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  10046 , 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)





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