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NPI Code Detail

MEDICARE: ABOVE (B2)

MEDICARE: ABOVE (B2)
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
1207P00000XEmergency Medicine Physician
2332900000XNon-Pharmacy Dispensing SiteD0013889MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801800198
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABOVE (B2)
Provider Business Mailing Address
First Line : PO BOX 6725
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-0725
Country : US
Telephone Number : 443-332-4260
Fax Number : 410-269-0510
Provider Business Practice Location Address
First Line : 2114 GENERALS HIGHWAY
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7488
Country : US
Telephone Number : 410-224-6483
Fax Number : 410-224-6404
Authorized Official
Title or Position : CHIEF OPERATING OPERATOR
Name : KIMBERLY A. BRESNAHAN
Credential :
Telephone Number : 443-332-4260
Provider Enumeration Date : 07/29/2006
Last Update Date : 10/24/2012

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Directions to “ABOVE (B2) ” Practice Location

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