Healthcare Provider Details

I. General information

NPI: 1881033496
Provider Name (Legal Business Name): CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 BOX HILL CORPORATE CENTER DR STE 120
ABINGDON MD
21009-1200
US

IV. Provider business mailing address

6707 DEMOCRACY BLVD STE 5004
BETHESDA MD
20817-1129
US

V. Phone/Fax

Practice location:
  • Phone: 410-377-8900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS PATRICK GROSSO
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 410-644-1880