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General NPI Number Information
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NPI Number | 1699419424
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Entity Type | Organization
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Legal Business Name | REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE, LLC
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 116 DEFENSE HWY STE 203
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7045
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Country | US
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Telephone | 108-624-5704
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Fax |
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Provider Business Mailing Address
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Address Line | 1760 OLD MEADOW RD STE 220
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City | MC LEAN
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State | VA
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Zip | 22102-4330
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Country | US
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Telephone | 855-461-1618
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOHN FERRELL
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Credential |
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Telephone | 301-825-7176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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