Healthcare Provider Details

I. General information

NPI: 1629013552
Provider Name (Legal Business Name): PATUXENT HOSPITALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 10/28/2009
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 1244
COLUMBIA MD
21044-0244
US

V. Phone/Fax

Practice location:
  • Phone: 410-997-5944
  • Fax: 410-997-1720
Mailing address:
  • Phone: 410-997-5944
  • Fax: 410-997-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. LAURA A NYANJOM
Title or Position: MANAGER
Credential:
Phone: 410-997-5944