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NPI Code Detail

MEDICARE: SLEEP DISORDERS CTRS OF THE MID ATLANTIC LLC

MEDICARE: SLEEP DISORDERS CTRS OF THE MID ATLANTIC LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical SuppliesMD
2261QS1200XSleep Disorder Diagnostic Clinic/CenterMD

General Provider Information

NPI Number : 1538339221
Entity Type Code : Organization
Provider Name (Legal Business Name) : SLEEP DISORDERS CTRS OF THE MID ATLANTIC LLC
Provider Business Mailing Address
First Line : 2235 CEDAR LN
Second Line : SUITE 202
City : VIENNA
State : VA
Zip : 22182-5202
Country : US
Telephone Number : 703-752-7881
Fax Number : 703-752-7880
Provider Business Practice Location Address
First Line : 71 OLD MILL BOTTOM RD N
Second Line : STE 102
City : ANNAPOLIS
State : MD
Zip : 21401-5410
Country : US
Telephone Number : 410-757-1297
Fax Number : 410-757-1299
Authorized Official
Title or Position : PRESIDENT
Name : JAMES R PERLSTROM
Credential : PHD
Telephone Number : 703-752-7881
Provider Enumeration Date : 03/10/2008
Last Update Date : 10/16/2008

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Directions to “SLEEP DISORDERS CTRS OF THE MID ATLANTIC LLC ” Practice Location

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