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General NPI Number Information
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NPI Number | 1780171579
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Entity Type | Organization
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Legal Business Name | MARYLAND INJURY CLINICS
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 4 PARK AVE STE 250
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2893
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Country | US
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Telephone | 301-869-9001
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Fax |
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Provider Business Mailing Address
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Address Line | 4 PARK AVE STE 250
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2893
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Country | US
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Telephone | 301-869-9001
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JHERSON ENRIQUE OROSCO MARINO
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Credential |
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Telephone | 301-869-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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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 | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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