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General NPI Number Information
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NPI Number | 1932924511
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Entity Type | Organization
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Legal Business Name | SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 375 PYTHIAN AVE
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City | OAKLAND
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State | MD
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Zip | 21550-5111
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Country | US
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Telephone | 304-334-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 375 PYTHIAN AVE
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City | OAKLAND
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State | MD
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Zip | 21550-5111
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | LORI DIXON
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Credential |
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Telephone | 301-533-4251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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