Provider Demographics
NPI:1205826724
Name:WASHINGTON COUNTY EMERGENCY MEDICINE PHYSICIANS, LLC
Entity Type:Organization
Organization Name:WASHINGTON COUNTY EMERGENCY MEDICINE PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-790-8372
Mailing Address - Street 1:PO BOX 631479
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-1479
Mailing Address - Country:US
Mailing Address - Phone:301-293-0232
Mailing Address - Fax:301-631-1002
Practice Address - Street 1:251 E ANTIETAM ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5724
Practice Address - Country:US
Practice Address - Phone:240-313-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS467OtherBCBS FEDERAL
PA0017209190002Medicaid
WV4000113000Medicaid
MDKF18OtherBCBS
MDCI1661OtherRAILROAD MEDICARE
MD613LMedicare ID - Type Unspecified