Healthcare Provider Details

I. General information

NPI: 1346354834
Provider Name (Legal Business Name): DIMENSIONS HEALTHCARE ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 HOSPITAL DR
CHEVERLY MD
20785-1189
US

IV. Provider business mailing address

3001 HOSPITAL DR
CHEVERLY MD
20785-1189
US

V. Phone/Fax

Practice location:
  • Phone: 443-462-5093
  • Fax: 410-793-0809
Mailing address:
  • Phone: 443-462-5093
  • Fax: 410-793-0809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DONNA WALLINGTON
Title or Position: PHYSICIAN PRACTICE MANAGER
Credential: CPC
Phone: 301-618-3655