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NPI Code Detail

MEDICARE: JAMES MAINHART PT

MEDICARE: JAMES MAINHART PT
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
12251X0800XOrthopedic Physical Therapist15828MD
22251S0007XSports Physical Therapist15828MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
26545-0004OTHERMDBLUE CHOICE
3236396OTHERMDMAMSI
44271165OTHERMDAETNA

General Provider Information

NPI Number : 1386630184
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MAINHART PT
Provider Business Mailing Address
First Line : 6011 UNIVERSITY BLVD
Second Line : SUITE 120
City : ELLICOTT CITY
State : MD
Zip : 21043-6074
Country : US
Telephone Number : 410-203-0391
Fax Number : 410-203-2707
Provider Business Practice Location Address
First Line : 6011 UNIVERSITY BLVD
Second Line : SUITE 120
City : ELLICOTT CITY
State : MD
Zip : 21043-6074
Country : US
Telephone Number : 410-203-0391
Fax Number : 410-203-2707
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 07/31/2014

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Directions to “ JAMES MAINHART PT” Practice Location

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