Provider Demographics
NPI:1033437272
Name:ENDOSCOPIC ASSOCIATES OF WALDORF PA
Entity Type:Organization
Organization Name:ENDOSCOPIC ASSOCIATES OF WALDORF PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-645-8035
Mailing Address - Street 1:12070 OLD LINE CTR STE 200
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2503
Mailing Address - Country:US
Mailing Address - Phone:301-645-8035
Mailing Address - Fax:301-645-5229
Practice Address - Street 1:11340 PEMBROOKE SQ
Practice Address - Street 2:SUITE 202
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4808
Practice Address - Country:US
Practice Address - Phone:301-645-8035
Practice Address - Fax:301-645-5229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty