MEDICARE: LHMG PHYSICAL THERAPY, 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
1	225100000X	Physical Therapist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	454595	OTHER	MD	MEDICARE

General Provider Information

NPI Number	:	1982214490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LHMG PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	2001 MEDICAL PKWY
Second Line	:	MEDICAL STAFF OFFICE
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401
Country	:	US
Telephone Number	:	443-481-5618
Fax Number	:	443-481-4151

Provider Business Practice Location Address
First Line	:	7611 CRAIN HWY STE 170
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-4258
Country	:	US
Telephone Number	:	443-481-1140
Fax Number	:	410-729-4526

Authorized Official
Title or Position	:	VICE PRESIDENT-PHYSICIAN SERVICES
Name	:	PETER ODENWALD
Credential	:
Telephone Number	:	443-481-6415

Provider Enumeration Date	:	08/10/2020
Last Update Date	:	01/28/2026

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Directions to “LHMG PHYSICAL THERAPY, LLC ” Practice Location

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