Healthcare Provider Details
I. General information
NPI: 1548550858
Provider Name (Legal Business Name): ALLEN MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/08/2011
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2300 GARRISON BLVD SUITE 200
BALTIMORE MD
21216-2335
US
IV. Provider business mailing address
3115 LORENZO LN
WOODBINE MD
21797-7501
US
V. Phone/Fax
- Phone: 410-233-3140
- Fax: 410-233-3222
- Phone: 410-299-8969
- Fax: 410-489-2361
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | D0056748 |
| License Number State | MD |
VIII. Authorized Official
Name: DR.
RHONDA
LYNN
ALLEN
Title or Position: OWNER
Credential: M.D.
Phone: 410-299-8969