MEDICARE: ALLERGY AND ASTHMA ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S877	OTHER		MEDICARE

General Provider Information

NPI Number	:	1043424161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY AND ASTHMA ASSOCIATES

Provider Business Mailing Address
First Line	:	277 PENINSULA FARM RD
Second Line	:
City	:	ARNOLD
State	:	MD
Zip	:	21012-1018
Country	:	US
Telephone Number	:	410-647-2600
Fax Number	:	410-647-4953

Provider Business Practice Location Address
First Line	:	277 PENINSULA FARM RD
Second Line	:
City	:	ARNOLD
State	:	MD
Zip	:	21012-1018
Country	:	US
Telephone Number	:	410-647-2600
Fax Number	:	410-647-4953

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. JAMES R. BANKS
Credential	:	MD
Telephone Number	:	410-647-2600

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	09/24/2015

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