Provider Demographics
NPI:1144395393
Name:NEUROMONITORING PHYSICIANS, LLC
Entity Type:Organization
Organization Name:NEUROMONITORING PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:MANDIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:202-444-7554
Mailing Address - Street 1:9115 KENDALE RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4512
Mailing Address - Country:US
Mailing Address - Phone:301-767-0015
Mailing Address - Fax:
Practice Address - Street 1:9115 KENDALE RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-4512
Practice Address - Country:US
Practice Address - Phone:301-767-0015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00541142084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G52075Medicare UPIN
G84458Medicare UPIN
MD907MMedicare ID - Type UnspecifiedNMP, LLC GROUP MEDICARE #