Healthcare Provider Details

I. General information

NPI: 1801454665
Provider Name (Legal Business Name): ORTHOPEDIC PHYSICIANS OF ANNAPOLIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8109 RITCHIE HWY STE 200
PASADENA MD
21122-6917
US

IV. Provider business mailing address

PO BOX 12522
BELFAST ME
04915-4016
US

V. Phone/Fax

Practice location:
  • Phone: 410-268-8862
  • Fax:
Mailing address:
  • Phone: 410-268-0380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ZUBAIR ANSARI
Title or Position: EX DIR PHYSICIAN REIMBURSEMENT
Credential:
Phone: 443-481-6521