Healthcare Provider Details

I. General information

NPI: 1548084940
Provider Name (Legal Business Name): SYNERGY PC VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6513 BAYTHORNE RD
BALTIMORE MD
21209-2637
US

IV. Provider business mailing address

6513 BAYTHORNE RD
BALTIMORE MD
21209-2637
US

V. Phone/Fax

Practice location:
  • Phone: 443-929-0404
  • Fax:
Mailing address:
  • Phone: 443-929-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAVID STEINBERG
Title or Position: TRUSTEE
Credential:
Phone: 443-929-0404