1376917070 NPI number — EMERGENCY MEDICINE ASSOCIATES, P.A.,P.C.

Table of content: (NPI 1376917070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376917070 NPI number — EMERGENCY MEDICINE ASSOCIATES, P.A.,P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMERGENCY MEDICINE ASSOCIATES, P.A.,P.C.
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:
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:
1376917070
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20010 CENTURY BLVD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GERMANTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20874-1118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-686-2320
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24440 STONE SPRINGS BOULEVARD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DULLES
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-574-6000
Provider Business Practice Location Address Fax Number:
202-373-3739
Provider Enumeration Date:
11/18/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CHASTAIN
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
PROVIDER ENROLLMENT
Authorized Official Telephone Number:
330-493-4443

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com