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General NPI Number Information
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NPI Number | 1083654479
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Entity Type | Organization
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Legal Business Name | FIVE STAR PHYSICIAN SERVICES, LLC
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 785 ELKRIDGE LANDING RD STE 300
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City | LINTHICUM HEIGHTS
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State | MD
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Zip | 21090-2958
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Country | US
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Telephone | 443-548-5700
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Fax | 443-548-5705
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Provider Business Mailing Address
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Address Line | P.O. BOX 2613
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City | SALISBURY
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State | MD
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Zip | 21802-2613
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Country | US
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Telephone | 443-548-5700
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Fax | 443-548-5705
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MS. RACHEL SETTING
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Credential |
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Telephone | 410-279-0317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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