Healthcare Provider Details
I. General information
NPI: 1790204030
Provider Name (Legal Business Name): CENTERS FOR ADVANCED ORTHOPAEDICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/19/2017
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3280 URBANA PIKE STE 105
IJAMSVILLE MD
21754-9411
US
IV. Provider business mailing address
6707 DEMOCRACY BLVD STE 504
BETHESDA MD
20817-1166
US
V. Phone/Fax
- Phone: 301-694-8311
- Fax: 301-694-3537
- Phone: 410-778-3445
- Fax: 410-778-3702
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
ROBINSON
Title or Position: CO
Credential:
Phone: 301-637-8712