Healthcare Provider Details

I. General information

NPI: 1689101321
Provider Name (Legal Business Name): CENTERS FOR ADVANCED ORTHOPAEDICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 03/13/2020
Certification Date: 03/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7556 TEAGUE RD SUITE 240
HANOVER MD
21076
US

IV. Provider business mailing address

6707 DEMOCRACY BLVD STE 504
BETHESDA MD
20817-1166
US

V. Phone/Fax

Practice location:
  • Phone: 410-768-5555
  • Fax: 410-799-1441
Mailing address:
  • Phone: 410-768-5555
  • Fax: 410-799-1441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD ROBINSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 301-637-8712