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NPI Code Detail

MEDICARE: BRIGHTSEAT SPECIALIST CARE

MEDICARE: BRIGHTSEAT SPECIALIST CARE
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
1207X00000XOrthopaedic Surgery Physician
2207V00000XObstetrics & Gynecology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11013094317OTHERMDNPI
21306837034OTHERMDNPI
31821141292OTHERMDNPI

General Provider Information

NPI Number : 1740574763
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIGHTSEAT SPECIALIST CARE
Provider Business Mailing Address
First Line : 1827 BRIGHTSEAT RD
Second Line :
City : LANDOVER
State : MD
Zip : 20785-4250
Country : US
Telephone Number : 301-386-6090
Fax Number :
Provider Business Practice Location Address
First Line : 1827 BRIGHTSEAT RD
Second Line :
City : LANDOVER
State : MD
Zip : 20785-4250
Country : US
Telephone Number : 301-386-6090
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : TERRIE L BALLENGER
Credential :
Telephone Number : 301-386-6090
Provider Enumeration Date : 06/07/2011
Last Update Date : 06/07/2011

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1043549751 — MRS. TERRI LYNN PETERS BSC., R.PH.
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1336442771 — INTEGRATED BEHAVIORAL HEALTH SOLUTIONS, LLC
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1871887893 — BRIGHTSEAT HEALTH
Practice Location Address:
1827 BRIGHTSEAT RD
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Practice Fax:

Directions to “BRIGHTSEAT SPECIALIST CARE ” Practice Location

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