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General NPI Number Information
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NPI Number | 1598944092
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Entity Type | Organization
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Legal Business Name | MID-ATLANTIC HEADACHE INSTITUTE INC
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 1777 REISTERSTOWN RD SUITE 104 WEST
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City | PIKESVILLE
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State | MD
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Zip | 21208-1306
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Country | US
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Telephone | 410-602-1999
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Fax | 410-602-1966
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Provider Business Mailing Address
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Address Line | 1777 REISTERSTOWN RD SUITE 104 WEST
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City | PIKESVILLE
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State | MD
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Zip | 21208-1306
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Country | US
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Telephone | 410-602-1999
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Fax | 410-602-1966
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARCIA CUOTO RIBEIRO
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Credential | M.D.
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Telephone | 410-602-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0051763
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License Number State | MD
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