Healthcare Provider Details
I. General information
NPI: 1457161523
Provider Name (Legal Business Name): PADDER HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/10/2025
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8850 COLUMBIA 100 PKWY STE 308
COLUMBIA MD
21045-2377
US
IV. Provider business mailing address
7350 VAN DUSEN RD STE 130
LAUREL MD
20707-5267
US
V. Phone/Fax
- Phone: 301-560-4747
- Fax: 301-776-1725
- Phone: 301-560-4747
- Fax: 301-776-1725
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FEROZ
AHMAD
PADDER
Title or Position: FOUNDER/PRESIDENT
Credential: MD
Phone: 301-560-4747