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NPI Code Detail

MEDICARE: MDICS REHABILITATIVE SERVICES LLC

MEDICARE: MDICS REHABILITATIVE SERVICES 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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1396586723
Entity Type Code : Organization
Provider Name (Legal Business Name) : MDICS REHABILITATIVE SERVICES LLC
Provider Business Mailing Address
First Line : 7250 PARKWAY DR STE 120
Second Line :
City : HANOVER
State : MD
Zip : 21076-1388
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 531 STEVENSON LN
Second Line :
City : TOWSON
State : MD
Zip : 21286-7607
Country : US
Telephone Number : 410-823-5310
Fax Number :
Authorized Official
Title or Position : CFO
Name : TIM DELBRUGGE
Credential :
Telephone Number : 301-693-8707
Provider Enumeration Date : 05/31/2024
Last Update Date : 05/31/2024

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