Healthcare Provider Details

I. General information

NPI: 1427897875
Provider Name (Legal Business Name): MARYLAND ONCOLOGY HEMATOLOGY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20330 SENECA MEADOWS PKWY # B
GERMANTOWN MD
20876-7004
US

IV. Provider business mailing address

11720 BELTSVILLE DR STE 300
BELTSVILLE MD
20705-3119
US

V. Phone/Fax

Practice location:
  • Phone: 301-424-6231
  • Fax: 301-294-4648
Mailing address:
  • Phone: 240-223-1893
  • Fax: 301-326-2926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT DAVIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 202-909-3301