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General NPI Number Information
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NPI Number | 1609680487
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Entity Type | Organization
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Legal Business Name | SIGNIFY HEALTH MEDICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 1910 TOWNE CENTRE BLVD STE 250
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3599
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Country | US
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Telephone | 877-868-5351
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Fax | 877-900-5078
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Provider Business Mailing Address
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Address Line | 4055 VALLEY VIEW LN STE 700
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City | DALLAS
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State | TX
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Zip | 75244-5045
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Country | US
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Telephone | 469-466-7424
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Fax |
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Authorized Official
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Title or Position | MANAGER, PROVIDER ENROLLMENT
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Name | ROBERT SHAWN BRONKE
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Credential |
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Telephone | 469-466-7424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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