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NPI Code Detail

MEDICARE: JOHN PRESTON M.D.

MEDICARE: JOHN PRESTON M.D.
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
1207L00000XAnesthesiology PhysicianD0058442MD

General Provider Information

NPI Number : 1134129190
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN PRESTON M.D.
Provider Business Mailing Address
First Line : 11085 LITTLE PATUXENT PKWY 004
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-2983
Country : US
Telephone Number : 410-730-0099
Fax Number :
Provider Business Practice Location Address
First Line : 301 HOSPITAL DR
Second Line :
City : GLEN BURNIE
State : MD
Zip : 21061-5803
Country : US
Telephone Number : 410-787-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 07/15/2015

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