Healthcare Provider Details

I. General information

NPI: 1023859980
Provider Name (Legal Business Name): MDICS REHABILITATIVE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SUDBROOK LN
PIKESVILLE MD
21208-4118
US

IV. Provider business mailing address

7250 PARKWAY DR STE 120
HANOVER MD
21076-1388
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-8771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TIM DELBRUGGE
Title or Position: CFO
Credential:
Phone: 301-693-8707