1376525956 NPI number — MORRIS M SHOCHET MD

Table of content: MORRIS M SHOCHET MD (NPI 1376525956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376525956 NPI number — MORRIS M SHOCHET MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHOCHET
Provider First Name:
MORRIS
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1376525956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN BURNIE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21061-5803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-787-4594
Provider Business Mailing Address Fax Number:
410-787-4846

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 HOSPITAL DR
Provider Second Line Business Practice Location Address:
ST 227
Provider Business Practice Location Address City Name:
GLEN BURNIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21061-6902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-553-8085
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/18/2005

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: 207RI0200X , with the licence number:  D0043429 , 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: 0242-0007 . This is a "CAREFIRST BLUE CROSS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1346569 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7556683 . This is a "AETNA PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 3865506 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 756921100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 26620 . This is a "JOHNS HOPKINS HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 525559-05 . This is a "CARE FIRST BLUE CROSS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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