Healthcare Provider Details

I. General information

NPI: 1629981709
Provider Name (Legal Business Name): ALLIANCE PHYSICIAN SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 RIDGELY AVE STE 222
ANNAPOLIS MD
21401-1073
US

IV. Provider business mailing address

600 RIDGELY AVE STE 130
ANNAPOLIS MD
21401-1045
US

V. Phone/Fax

Practice location:
  • Phone: 410-266-8049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAMES J WEBER
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 214-424-2213