Healthcare Provider Details

I. General information

NPI: 1427395730
Provider Name (Legal Business Name): HEALTHMSO OF MARYLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9707 MEDICAL CENTER DR SUITE 200
ROCKVILLE MD
20850-3348
US

IV. Provider business mailing address

PO BOX 1071
BOCA RATON FL
33429-1071
US

V. Phone/Fax

Practice location:
  • Phone: 301-693-7001
  • Fax: 703-444-4308
Mailing address:
  • Phone: 301-693-7001
  • Fax: 703-444-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PANKAJ MERCHIA
Title or Position: MANAGER
Credential:
Phone: 301-693-7001