1003285891 NPI number — ARNOLD S KIRSHENBAUM MD PA

Table of content: (NPI 1003285891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003285891 NPI number — ARNOLD S KIRSHENBAUM MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARNOLD S KIRSHENBAUM MD PA
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:
1003285891
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12150 ANNAPOLIS RD
Provider Second Line Business Mailing Address:
SUITE #108
Provider Business Mailing Address City Name:
GLENN DALE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20769-9183
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-860-1200
Provider Business Mailing Address Fax Number:
301-860-0050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12150 ANNAPOLIS RD
Provider Second Line Business Practice Location Address:
SUITE #108
Provider Business Practice Location Address City Name:
GLENN DALE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20769-9183
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-860-1200
Provider Business Practice Location Address Fax Number:
301-860-0050
Provider Enumeration Date:
09/22/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KIRSHENBAUM
Authorized Official First Name:
ARNOLD
Authorized Official Middle Name:
SETH
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
301-860-1200

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D33409 , 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: 1831145903 . This is a "NATIONAL PROVIDER IDENTIFIER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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