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General NPI Number Information
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NPI Number | 1962620062
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Entity Type | Organization
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Legal Business Name | DRS. DIMARZIO,GORDON,JACKSON,KINZER,MILLER&VERKOUW, PA
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 2003 MEDICAL PKWY SUITE 100
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7992
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Country | US
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Telephone | 410-573-1110
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Fax | 410-266-0714
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Provider Business Mailing Address
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Address Line | 2003 MEDICAL PKWY SUITE 100
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7992
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Country | US
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Telephone | 410-573-1110
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Fax | 410-266-0714
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. DEBBIE A INZER
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Credential |
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Telephone | 410-573-1110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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