Healthcare Provider Details
I. General information
NPI: 1962853119
Provider Name (Legal Business Name): CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2016
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 HOSPITAL DR EMPIRE MED BLDG
GLEN BURNIE MD
21061
US
IV. Provider business mailing address
6707 DEMOCRACY BLVD STE 504
BETHESDA MD
20817-1166
US
V. Phone/Fax
- Phone: 410-768-5555
- Fax: 410-768-5835
- Phone: 410-768-5555
- Fax: 410-768-5835
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
ROBINSON
Title or Position: COO
Credential:
Phone: 301-637-8712