Healthcare Provider Details

I. General information

NPI: 1528213139
Provider Name (Legal Business Name): ALLERGY & ASTHMA CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2008
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 GREENWAY CENTER DRIVE SUTIE # 214
GREENBELT MD
20770
US

IV. Provider business mailing address

602 SOUTH ATWOOD ROAD SUITE # 202
BEL AIR MD
21014
US

V. Phone/Fax

Practice location:
  • Phone: 301-474-8118
  • Fax: 301-345-1271
Mailing address:
  • Phone: 410-638-1999
  • Fax: 410-638-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0046941
License Number StateMD

VIII. Authorized Official

Name: MISS MELISSA A DUNN
Title or Position: BILLING
Credential:
Phone: 410-638-1999