Healthcare Provider Details

I. General information

NPI: 1629441241
Provider Name (Legal Business Name): CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 03/13/2020
Certification Date: 03/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 TALBOT BLVD SUITE W
CHESTERTOWN MD
21620
US

IV. Provider business mailing address

6707 DEMOCRACY BLVD STE 504
BETHESDA MD
20817-1166
US

V. Phone/Fax

Practice location:
  • Phone: 410-778-3445
  • Fax: 410-778-3702
Mailing address:
  • Phone: 410-778-3445
  • Fax: 410-778-3702

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: MR. RICHARD ROBINSON
Title or Position: COO
Credential:
Phone: 301-637-8712