Healthcare Provider Details

I. General information

NPI: 1679268908
Provider Name (Legal Business Name): DOT EXAM EXPRESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 BENSON AVE
HALETHORPE MD
21227-1410
US

IV. Provider business mailing address

4601 BENSON AVE
HALETHORPE MD
21227-1410
US

V. Phone/Fax

Practice location:
  • Phone: 443-234-9277
  • Fax: 443-234-9308
Mailing address:
  • Phone: 443-234-9277
  • Fax: 443-234-9308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK E INGRAM
Title or Position: CEO
Credential: DC
Phone: 443-540-2294