NPI Code Detail JSON Logo

1548969322 NPI number — PREMISE HEALTH OF MARYLAND MEDICAL PC

NPI Number: 1548969322
Health Care Provider/Practitioner: PREMISE HEALTH OF MARYLAND MEDICAL PC

Information about “1548969322” NPI (PREMISE HEALTH OF MARYLAND MEDICAL PC) exists in 1548969322 in HTML format HTML  |  1548969322 in plain Text format TXT  |  1548969322 in PDF (Portable Document Format) PDF  |  1548969322 in an XML format XML  formats.

NPI Number : 1548969322 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1548969322",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PREMISE HEALTH OF MARYLAND MEDICAL PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5500 MARYLAND WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRENTWOOD",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37027-7048",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "16301 ELLIOTT PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WILLIAMSPORT",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21795-4081",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "240-313-3818",
    "PracticeLocationAddressFaxNumber": "240-673-3823",
    "EnumerationDate": "03/01/2023",
    "LastUpdateDate": "02/12/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SCHWARTZ",
    "AuthorizedOfficialFirstName": "EDWARD",
    "AuthorizedOfficialMiddleName": "WILLIAM",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "844-407-7557",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QM1300X",
        "TaxonomyName": "Multi-Specialty Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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