Healthcare Provider Details

I. General information

NPI: 1366417289
Provider Name (Legal Business Name): R MARSHALL ACKERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BLACKWELL RD STE 100
ROCKVILLE MD
20850-6477
US

IV. Provider business mailing address

9601 BLACKWELL RD STE 100
ROCKVILLE MD
20850-6477
US

V. Phone/Fax

Practice location:
  • Phone: 301-340-9200
  • Fax: 301-340-6934
Mailing address:
  • Phone: 301-340-9200
  • Fax: 301-340-6934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0002443
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0002443
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: