Provider Demographics
NPI:1164594453
Name:HAROLD I. RODMAN, M.D. & JOEL M. ENGELSTEIN. M.D.
Entity Type:Organization
Organization Name:HAROLD I. RODMAN, M.D. & JOEL M. ENGELSTEIN. M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-588-1177
Mailing Address - Street 1:8630 FENTON ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3806
Mailing Address - Country:US
Mailing Address - Phone:301-588-1177
Mailing Address - Fax:301-589-5245
Practice Address - Street 1:8630 FENTON ST
Practice Address - Street 2:SUITE 130
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3806
Practice Address - Country:US
Practice Address - Phone:301-588-1177
Practice Address - Fax:301-589-5245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409708Medicare PIN