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General NPI Number Information
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NPI Number | 1427407386
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Entity Type | Organization
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Legal Business Name | MARYLAND NEURODIAGNOSTICS, LLC
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 300 CHARLES ST
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City | LA PLATA
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State | MD
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Zip | 20646-3582
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Country | US
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Telephone | 240-654-0277
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Fax | 866-279-4704
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Provider Business Mailing Address
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Address Line | 4545 FULLER DR SUITE 100
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City | IRVING
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State | TX
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Zip | 75038-6530
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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 | CEO
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Name | CHARLES ALVAREZ
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Credential |
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Telephone | 305-807-8072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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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 | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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