Healthcare Provider Details

I. General information

NPI: 1750784294
Provider Name (Legal Business Name): ORTHOPEDIC PHYSICIANS OF ANNAPOLIS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 05/12/2015
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

2000 MEDICAL PKWY STE 101
ANNAPOLIS MD
21401-3742
US

V. Phone/Fax

Practice location:
  • Phone: 410-268-8862
  • Fax: 410-280-4701
Mailing address:
  • Phone: 410-268-8862
  • Fax: 410-280-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: ROBERT M VERKLIN JR.
Title or Position: PHYSICIAN
Credential: MD
Phone: 410-295-8900