1023387701 NPI number — MEDICINE INVENTION DESIGN INCORPORATION

Table of content: (NPI 1023387701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023387701 NPI number — MEDICINE INVENTION DESIGN INCORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICINE INVENTION DESIGN INCORPORATION
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:
1023387701
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5545 BURNSIDE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20853-2458
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-222-7143
Provider Business Mailing Address Fax Number:
866-458-0099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5545 BURNSIDE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20853-2458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-222-7143
Provider Business Practice Location Address Fax Number:
866-458-0099
Provider Enumeration Date:
12/23/2011

Additional Information

Authorized Official

Authorized Official Last Name:
XU
Authorized Official First Name:
HAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO/SD/PI/SPONSOR/CHAIR
Authorized Official Telephone Number:
301-222-7143

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR1100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835P0018X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336I0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336M0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 302R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: FWA00015357 . This is a "HHS-OHRP-FWA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 69891 . This is a "FDA-NDC-LABELER-CODE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: D11379922 . This is a "MD-SDAT" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: IRB00009294 . This is a "HHS-OHRP-IRB" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: IORG0007849 . This is a "HHS-OHRP-IORG" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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