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General NPI Number Information
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NPI Number | 1164759858
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Entity Type | Organization
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Legal Business Name | SLEEP DISORDERS CTRS OF THE MID ATLANTIC LLC
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 7671 QUARTERFIELD RD SUITE 201
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4998
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Country | US
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Telephone | 410-582-9300
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Fax | 410-582-9301
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Provider Business Mailing Address
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Address Line | 2235 CEDAR LN SUITE 202
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City | VIENNA
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State | VA
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Zip | 22182-5202
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Country | US
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Telephone | 703-752-7881
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Fax | 703-752-7880
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. JAMES R PERLSTROM
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Credential | PHD,
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Telephone | 703-752-7881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | MD
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