1750386793 NPI number — DR. JEFFREY S GARBIS M.D.

Table of content: DR. JEFFREY S GARBIS M.D. (NPI 1750386793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750386793 NPI number — DR. JEFFREY S GARBIS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARBIS
Provider First Name:
JEFFREY
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1750386793
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7350 VAN DUSEN RD
Provider Second Line Business Mailing Address:
STE 250
Provider Business Mailing Address City Name:
LAUREL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20707-5268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-498-5500
Provider Business Mailing Address Fax Number:
301-498-7346

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7350 VAN DUSEN RD
Provider Second Line Business Practice Location Address:
STE 210
Provider Business Practice Location Address City Name:
LAUREL
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20707-5268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-498-5500
Provider Business Practice Location Address Fax Number:
301-498-7346
Provider Enumeration Date:
06/16/2005

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: 207RG0100X , with the licence number:  D0018325 , 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: 2516-0003 . This is a "CAREFIRST BS DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: A1130005 . This is a "CAREFIRST BCBS DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: N5630031 . This is a "CAREFIRST MD/DC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: P00679083 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 319641100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 320210-01 . This is a "CAREFIRST BSMD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: A1110004 . This is a "CAREFIRST BCBS DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 160000959 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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