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1326618448

NPI Code Detail

MEDICARE: NORTH BAY ENT & AUDIOLOGY GROUP LLC

MEDICARE: NORTH BAY ENT & AUDIOLOGY GROUP 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
1	231H00000X	Audiologist
2	237600000X	Audiologist-Hearing Aid Fitter
3	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1326618448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BAY ENT & AUDIOLOGY GROUP LLC

Provider Business Mailing Address
First Line	:	520 UPPER CHESAPEAKE DR STE 206
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21014-4360
Country	:	US
Telephone Number	:	410-879-9100
Fax Number	:	410-638-0408

Provider Business Practice Location Address
First Line	:	520 UPPER CHESAPEAKE DR STE 206
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21014-4360
Country	:	US
Telephone Number	:	410-879-9100
Fax Number	:	410-638-0408

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	JANELLE ADOLPH
Credential	:
Telephone Number	:	410-688-9753

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	11/02/2023

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Directions to “NORTH BAY ENT & AUDIOLOGY GROUP LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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