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NPI Code Detail

MEDICARE: PATIENT FIRST MARYLAND MEDICAL GROUP PLLC

MEDICARE: PATIENT FIRST MARYLAND MEDICAL GROUP PLLC
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
1261QU0200XUrgent Care Clinic/Center
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1568016392
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATIENT FIRST MARYLAND MEDICAL GROUP PLLC
Provider Business Mailing Address
First Line : 5000 COX RD
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-9263
Country : US
Telephone Number : 804-968-5700
Fax Number :
Provider Business Practice Location Address
First Line : 21044 FREDERICK RD
Second Line :
City : GERMANTOWN
State : MD
Zip : 20876-4132
Country : US
Telephone Number : 240-238-5432
Fax Number : 240-238-5433
Authorized Official
Title or Position : PRESIDENT
Name : GEORGE HARRIS MORISON
Credential :
Telephone Number : 804-968-5700
Provider Enumeration Date : 07/30/2019
Last Update Date : 03/05/2024

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