1184188500 NPI number — MR. GARY ALEXANDER HORSEY M.A.

Table of content: MR. GARY ALEXANDER HORSEY M.A. (NPI 1184188500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184188500 NPI number — MR. GARY ALEXANDER HORSEY M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORSEY
Provider First Name:
GARY
Provider Middle Name:
ALEXANDER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
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:
1184188500
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11504 ACCOLADE CT.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20735
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-699-1141
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6188 OXON HILL ROAD
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
OXON HILL
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20745-3136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-567-0400
Provider Business Practice Location Address Fax Number:
301-567-0400
Provider Enumeration Date:
01/30/2019

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: 101YP2500X , with the licence number:  LGP8967 , 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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