Healthcare Provider Details

I. General information

NPI: 1740421882
Provider Name (Legal Business Name): TWINDOC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2009
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12805 OLD FORT RD STE 201
FORT WASHINGTON MD
20744
US

IV. Provider business mailing address

12805 OLD FORT RD # 102
FORT WASHINGTON MD
20744-2874
US

V. Phone/Fax

Practice location:
  • Phone: 301-292-1960
  • Fax:
Mailing address:
  • Phone: 301-292-1960
  • Fax: 301-292-1068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS03538
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DARELL ANDREWS
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 443-597-6842