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NPI Code Detail

MEDICARE: MARCUS PATTERSON

MEDICARE: MARCUS PATTERSON
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1093358814
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCUS PATTERSON
Provider Business Mailing Address
First Line : 501 FAIRMOUNT AVE STE 302
Second Line :
City : TOWSON
State : MD
Zip : 21286-5494
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8890 CENTRE PARK DR STE 400
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2170
Country : US
Telephone Number : 410-884-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2019
Last Update Date : 10/24/2019

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Directions to “ MARCUS PATTERSON ” Practice Location

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