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NPI Code Detail

MEDICARE: MARYLAND REAL LIFE DESIGNS, LLC

MEDICARE: MARYLAND REAL LIFE DESIGNS, LLC
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
1335E00000XProsthetic/Orthotic Supplier12027054MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124028535
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARYLAND REAL LIFE DESIGNS, LLC
Provider Business Mailing Address
First Line : 3435 BOX HILL CORPORATE CENTER DR
Second Line : SUITE D
City : ABINGDON
State : MD
Zip : 21009-1204
Country : US
Telephone Number : 410-569-0606
Fax Number : 410-569-7477
Provider Business Practice Location Address
First Line : 3435 BOX HILL CORPORATE CENTER DR
Second Line : SUITE D
City : ABINGDON
State : MD
Zip : 21009-1204
Country : US
Telephone Number : 410-569-0606
Fax Number : 410-569-7477
Authorized Official
Title or Position : MEMBER/ PRESIDENT
Name : PROF. JONAS W SEEBERG
Credential : CPO
Telephone Number : 410-569-0606
Provider Enumeration Date : 07/28/2005
Last Update Date : 01/11/2022

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Practice Location Address:
3435 BOX HILL CORPORATE CENTER DR , SUITE D
ABINGDON, MD
21009-1204
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Practice Fax: 410-569-7477

Directions to “MARYLAND REAL LIFE DESIGNS, LLC ” Practice Location

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