MEDICARE: DR. MICHAEL MARDINEY III 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
1	207K00000X	Allergy & Immunology Physician	D0043585	MD

General Provider Information

NPI Number	:	1609827724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL MARDINEY III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 609
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21041-0609
Country	:	US
Telephone Number	:	410-461-4500
Fax Number	:	410-461-4525

Provider Business Practice Location Address
First Line	:	3105 N RIDGE RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-3348
Country	:	US
Telephone Number	:	410-461-7660
Fax Number	:	410-461-2853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	08/01/2017

Similar Medicare Providers

1023143138 — MICHAEL R MARDINEY JR MD PA
Practice Location Address:

3105 N RIDGE RD
ELLICOTT CITY, MD
21043-3348

Practice Phone: 410-461-7660
Practice Fax:

1407239510 — MICHAEL MARDINEY, III, M.D. P.A.
Practice Location Address:

3105 N RIDGE RD
ELLICOTT CITY, MD
21043-3348

Practice Phone: 410-461-7660
Practice Fax: 410-461-2853

1023086873 — MANOHAR R. MANCHANDIA MD
Practice Location Address:

2706 SHED RD
BOSSIER CITY, LA
71111-3348

Practice Phone: 318-747-5272
Practice Fax: 318-746-9669

1396782587 — SSM REGIONAL HEALTH SERVICES
Practice Location Address:

3348 AMERICAN AVE
JEFFERSON CITY, MO
65109-1079

Practice Phone: 573-761-7210
Practice Fax: 573-634-8802

1992731301 — WILLIS KNIGHTON MEDICAL CENTER & M R MANCHANDIA
Practice Location Address:

2706 SHED RD
BOSSIER CITY, LA
71111-3348

Practice Phone: 318-747-5272
Practice Fax: 318-746-9669

1063440154 — DR. WILLIAM BUSBY M.D.
Practice Location Address:

3348 AMERICAN AVE
JEFFERSON CITY, MO
65109-1079

Practice Phone: 573-761-7210
Practice Fax: 573-634-8802

Directions to “ DR. MICHAEL MARDINEY III M.D.” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.