Healthcare Provider Details

I. General information

NPI: 1669536207
Provider Name (Legal Business Name): ORTHOPEDIC AND HAND SURG ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 12/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 S NORTH POINT RD
BALTIMORE MD
21224
US

IV. Provider business mailing address

1050 S NORTH POINT RD
BALTIMORE MD
21224
US

V. Phone/Fax

Practice location:
  • Phone: 410-282-7600
  • Fax: 410-282-4802
Mailing address:
  • Phone: 410-282-7600
  • Fax: 410-282-4802

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 Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DEANNA MILLER
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 410-282-7600