Provider Demographics
NPI:1154308336
Name:METRO WASH ORTHO ASSOCIATION
Entity Type:Organization
Organization Name:METRO WASH ORTHO ASSOCIATION
Other - Org Name:PHYSICAL MEDICINE REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RIDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:AZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-839-3373
Mailing Address - Street 1:PO BOX 1077
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20750-1077
Mailing Address - Country:US
Mailing Address - Phone:301-839-3373
Mailing Address - Fax:301-749-0027
Practice Address - Street 1:6144 OXON HILL RD
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3107
Practice Address - Country:US
Practice Address - Phone:301-839-3373
Practice Address - Fax:301-749-0027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD440521804Medicaid
MD159647Medicare PIN
MD5120950001Medicare NSC