Healthcare Provider Details

I. General information

NPI: 1013422070
Provider Name (Legal Business Name): PENINSULA ORTHOPAEDIC ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2017
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GLEN AVE UNIT 203
SALISBURY MD
21804-5250
US

IV. Provider business mailing address

PO BOX 69709
BALTIMORE MD
21264-9709
US

V. Phone/Fax

Practice location:
  • Phone: 410-749-4154
  • Fax: 410-749-4154
Mailing address:
  • Phone: 410-860-4506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY JOHN ADRIGNOLO
Title or Position: MD
Credential:
Phone: 410-749-4154