Provider Demographics
NPI:1003810078
Name:MARYLAND ORTHOTICS AND PROSTHETICS CO. INC
Entity Type:Organization
Organization Name:MARYLAND ORTHOTICS AND PROSTHETICS CO. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-977-9853
Mailing Address - Street 1:7600 OSLER DR STE 210
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7701
Mailing Address - Country:US
Mailing Address - Phone:410-665-8200
Mailing Address - Fax:410-665-2405
Practice Address - Street 1:7600 OSLER DR STE 210
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7701
Practice Address - Country:US
Practice Address - Phone:410-665-8200
Practice Address - Fax:410-665-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD333718900Medicaid
MD0156560001Medicare NSC
MD333718900Medicaid