Healthcare Provider Details

I. General information

NPI: 1093126286
Provider Name (Legal Business Name): ARTURO MEJIA SA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2014
Last Update Date: 05/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 NORTHCLIFFE DR
ROCKVILLE MD
20850-3024
US

IV. Provider business mailing address

630 NORTHCLIFFE DR
ROCKVILLE MD
20850-3024
US

V. Phone/Fax

Practice location:
  • Phone: 301-520-1454
  • Fax:
Mailing address:
  • Phone: 301-520-1454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number12-199
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: