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General NPI Number Information
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NPI Number | 1528171840
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Entity Type | Organization
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Legal Business Name | DOCTORS EMERGENCY SERVICE, PA
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 2001 MEDICAL PKWY
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3280
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Country | US
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Telephone | 443-481-1366
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 FRANKLIN SQUARE DR STE B
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City | BALTIMORE
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State | MD
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Zip | 21236-5915
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Country | US
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Telephone | 410-931-0400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH S GUMMERSON
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Credential | M.D.
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Telephone | 443-481-1366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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