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General NPI Number Information
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NPI Number | 1962531848
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Entity Type | Organization
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Legal Business Name | PREMIER ORTHOPEDICS, P.A.
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 3570 SAINT JOHNS LN FREDERICK CROSSING
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-4020
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Country | US
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Telephone | 410-461-9500
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Fax | 410-461-8945
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Provider Business Mailing Address
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Address Line | 3570 SAINT JOHNS LN FREDERICK CROSSING
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-4020
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Country | US
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Telephone | 410-461-9500
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Fax | 410-461-8945
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Authorized Official
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Title or Position | PRACTICE COORDINATOR
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Name | MYRA BUSCH
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Credential |
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Telephone | 410-461-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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