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General NPI Number Information
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NPI Number | 1437881000
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Entity Type | Organization
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Legal Business Name | COLUMBIA JOINT HEALTH LLC
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 7130 MINSTREL WAY STE 210
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City | COLUMBIA
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State | MD
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Zip | 21045-5265
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Country | US
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Telephone | 410-575-3998
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Fax |
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Provider Business Mailing Address
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Address Line | 3313 CASTLE RIDGE CIR
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City | SILVER SPRING
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State | MD
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Zip | 20904-7343
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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 | MANAGING MEMBER
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Name | ABEL DEREJE
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Credential |
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Telephone | 410-575-3998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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