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General NPI Number Information
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NPI Number | 1699517128
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Entity Type | Organization
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Legal Business Name | MARYLAND ONCOLOGY HEMATOLOGY, P.A.
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 5961 EXCHANGE DR STE 100
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City | ELDERSBURG
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State | MD
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Zip | 21784-9266
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Country | US
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Telephone | 410-964-2122
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Fax | 410-964-0380
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Provider Business Mailing Address
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Address Line | 11720 BELTSVILLE DR STE 300
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City | BELTSVILLE
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State | MD
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Zip | 20705-3119
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Country | US
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Telephone | 240-223-1893
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Fax | 301-326-2926
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROBERT DAVIS
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Credential |
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Telephone | 202-909-3301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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