Healthcare Provider Details

I. General information

NPI: 1033381918
Provider Name (Legal Business Name): CEDAR HOUSE PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 CEDAR LN
COLUMBIA MD
21044-2912
US

IV. Provider business mailing address

PO BOX 13377
PHILADELPHIA PA
19101-3377
US

V. Phone/Fax

Practice location:
  • Phone: 410-740-7890
  • Fax:
Mailing address:
  • Phone: 215-442-5000
  • Fax: 215-957-2875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID MEYERS
Title or Position: OWNER
Credential:
Phone: 800-355-0808