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General NPI Number Information
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NPI Number | 1487286050
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Entity Type | Organization
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Legal Business Name | UM FDSP ASSOCIATES, P.A.
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 9631 GUDELSKY DRIVE SUITE 2135
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City | ROCKVILLE
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State | MD
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Zip | 20850
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Country | US
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Telephone | 240-665-6700
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Fax | 410-706-3028
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Provider Business Mailing Address
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Address Line | 650 W BALTIMORE ST RM 5201
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City | BALTIMORE
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State | MD
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Zip | 21201-1510
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Country | US
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Telephone | 410-706-5806
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Fax | 410-706-3028
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Authorized Official
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Title or Position | DIR. OF MEDICAL CREDENTIALING & QA
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Name | ELYSE B MARKWITZ
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Credential |
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Telephone | 410-706-5806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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