Healthcare Provider Details

I. General information

NPI: 1831748383
Provider Name (Legal Business Name): MARIANNA GARRIGAN ADAMS BS, NRP, CCISM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2019
Last Update Date: 09/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 ADY RD
FOREST HILL MD
21050-1707
US

IV. Provider business mailing address

1641 MAIN ST
WHITEFORD MD
21160-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-638-4700
  • Fax: 410-638-4701
Mailing address:
  • Phone: 410-487-3612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number0112727
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: