Healthcare Provider Details

I. General information

NPI: 1346806502
Provider Name (Legal Business Name): SPECIALTY PHYSICIANS OF GARRETT COUNTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 CORPORATE DR
GRANTSVILLE MD
21536-1259
US

IV. Provider business mailing address

PO BOX 594
OAKLAND MD
21550-4594
US

V. Phone/Fax

Practice location:
  • Phone: 301-895-8750
  • Fax: 301-895-8751
Mailing address:
  • Phone: 301-895-8750
  • Fax: 301-895-8751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LORI DIXON
Title or Position: DIRECTOR FINANCE
Credential:
Phone: 301-533-4251