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General NPI Number Information
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NPI Number | 1083766646
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Entity Type | Organization
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Legal Business Name | ATLANTIC MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 10952 BASKERVILLE RD
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City | REISTERSTOWN
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State | MD
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Zip | 21136-6406
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Country | US
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Telephone | 410-356-5761
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 295
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City | REISTERSTOWN
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State | MD
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Zip | 21136-0295
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Country | US
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Telephone | 410-356-5761
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LARISA LEYTMAN
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Credential |
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Telephone | 410-356-5761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 193773
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License Number State | MD
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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 | 20011
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License Number State | MD
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