Provider Demographics
NPI:1225359995
Name:MARYLAND ORTHOPEDIC MEDICINE, LLC
Entity Type:Organization
Organization Name:MARYLAND ORTHOPEDIC MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-588-7888
Mailing Address - Street 1:8401 COLESVILLE RD
Mailing Address - Street 2:SUITE 50
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3312
Mailing Address - Country:US
Mailing Address - Phone:301-588-7888
Mailing Address - Fax:301-588-3419
Practice Address - Street 1:8401 COLESVILLE RD
Practice Address - Street 2:SUITE 50
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3312
Practice Address - Country:US
Practice Address - Phone:301-588-7888
Practice Address - Fax:301-588-3419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002041363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty