1972306074 NPI number — CENTERS FOR ADVANCED ORTHOPAEDICS, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972306074 NPI number — CENTERS FOR ADVANCED ORTHOPAEDICS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
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:
1972306074
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6707 DEMOCRACY BLVD STE 504
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20817-1166
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10285 LITTLE PATUXENT PKWY STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044-3489
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-644-1880
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2025

Additional Information

Authorized Official

Authorized Official Last Name:
GROSSO
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
PATRICK
Authorized Official Title or Position:
PRINCIPLE PHYSICIAN
Authorized Official Telephone Number:
410-644-1880

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; 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