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General NPI Number Information
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NPI Number | 1346642303
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Entity Type | Organization
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Legal Business Name | MAGELLAN HEALTHCARE PROVIDER GROUP, INC.
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 09/22/2014
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Provider Practice Location Address
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Address Line | 6950 COLUMBIA GATEWAY DR
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City | COLUMBIA
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State | MD
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Zip | 21046-2706
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Country | US
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Telephone | 410-953-4702
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Fax |
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Provider Business Mailing Address
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Address Line | 6950 COLUMBIA GATEWAY DR
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City | COLUMBIA
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State | MD
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Zip | 21046-2706
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ATTORNEY
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Name | MR. ANDREW CUMMINGS
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Credential |
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Telephone | 212-943-2852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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