Healthcare Provider Details

I. General information

NPI: 1659833192
Provider Name (Legal Business Name): CHRISTOPHER FILOSA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12500 WILLOWBROOK RD
CUMBERLAND MD
21502-6393
US

IV. Provider business mailing address

12500 WILLOWBROOK RD
CUMBERLAND MD
21502-6393
US

V. Phone/Fax

Practice location:
  • Phone: 240-964-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberD0106517
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: