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1427380302 NPI number — MARYLAND IVF FERTILITY HEALTH & WELLNESS CENTER

NPI Number: 1427380302
Health Care Provider/Practitioner: MARYLAND IVF FERTILITY HEALTH & WELLNESS CENTER

Information about “1427380302” NPI (MARYLAND IVF FERTILITY HEALTH & WELLNESS CENTER) exists in 1427380302 in HTML format HTML  |  1427380302 in plain Text format TXT  |  1427380302 in PDF (Portable Document Format) PDF  |  1427380302 in an XML format XML  formats.

NPI Number : 1427380302 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1427380302",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MARYLAND IVF FERTILITY HEALTH & WELLNESS CENTER",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9250 BENDIX RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLUMBIA",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21045-1832",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "410-964-2229",
    "MailingAddressFaxNumber": "410-964-0009",
    "FirstLinePracticeLocationAddress": "11055 LITTLE PATUXENT PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLUMBIA",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21044-2896",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "410-964-2229",
    "PracticeLocationAddressFaxNumber": "410-964-0009",
    "EnumerationDate": "02/03/2010",
    "LastUpdateDate": "02/03/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BROOMFIELD",
    "AuthorizedOfficialFirstName": "DIANA",
    "AuthorizedOfficialMiddleName": "P",
    "AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "410-964-2229",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QH0100X",
          "TaxonomyName": "Health Service Clinic/Center",
          "LicenseNumber": "MD034987",
          "LicenseNumberStateCode": "DC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM2500X",
          "TaxonomyName": "Medical Specialty Clinic/Center",
          "LicenseNumber": "0101234644",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM2500X",
          "TaxonomyName": "Medical Specialty Clinic/Center",
          "LicenseNumber": "D0060312",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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