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General NPI Number Information
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NPI Number | 1063692291
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Entity Type | Organization
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Legal Business Name | PATUXENT RHEUMATOLOGY ASSOCIATES,LLC
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 995 N. PRINCE FREDERICK BLVD SUITE 103
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-3151
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Country | US
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Telephone | 410-414-3437
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Fax | 410-414-3451
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Provider Business Mailing Address
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Address Line | PO BOX 424
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-0424
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Country | US
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Telephone | 410-414-3437
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Fax | 410-414-3451
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ASHA GEORGE
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Credential | MD
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Telephone | 410-414-3437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | D0059442
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License Number State | MD
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