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General NPI Number Information
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NPI Number | 1679639256
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Entity Type | Organization
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Legal Business Name | EDWARD M. EISENBREY,M.D.,P.A.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3050 CRAIN HWY SUITE 301 AND 302
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City | WALDORF
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State | MD
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Zip | 20601-2824
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Country | US
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Telephone | 301-843-5333
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Fax | 301-870-9988
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Provider Business Mailing Address
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Address Line | 3050 CRAIN HWY SUITE 301 AND 302
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City | WALDORF
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State | MD
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Zip | 20601-2824
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Country | US
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Telephone | 301-843-5333
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Fax | 301-870-9988
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD MARSTON EISENBREY
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Credential | M.D.
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Telephone | 301-843-5333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | D0017291
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | D16180
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License Number State | MD
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