Healthcare Provider Details

I. General information

NPI: 1871708347
Provider Name (Legal Business Name): ORTHOPAEDIC ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8322 BELLONA AVE SUITE 204
TOWSON MD
21204-2012
US

IV. Provider business mailing address

8322 BELLONA AVE SUITE 204
TOWSON MD
21204-2012
US

V. Phone/Fax

Practice location:
  • Phone: 410-337-5418
  • Fax: 410-337-5305
Mailing address:
  • Phone: 410-337-5418
  • Fax: 410-337-5305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BETH MCCONNELL
Title or Position: MANAGER
Credential:
Phone: 410-337-5418