Healthcare Provider Details

I. General information

NPI: 1639153521
Provider Name (Legal Business Name): ARTHRITIS CARE SPECIALISTS OF MARYLAND, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2005
Last Update Date: 09/08/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 STEVENS FOREST RD STE 101
COLUMBIA MD
21046-3240
US

IV. Provider business mailing address

6350 STEVENS FOREST RD STE 101
COLUMBIA MD
21046-3240
US

V. Phone/Fax

Practice location:
  • Phone: 410-992-7440
  • Fax: 443-276-0349
Mailing address:
  • Phone: 410-992-7440
  • Fax: 443-276-0349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberD57718
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberD22448
License Number StateMD

VIII. Authorized Official

Name: DR. PAUL ALAN GERTLER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-992-7440