Provider Demographics
NPI:1235399494
Name:MARYLAND ORTHOTICS AND PROSTHETICS CO., INC
Entity Type:Organization
Organization Name:MARYLAND ORTHOTICS AND PROSTHETICS CO., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-977-1945
Mailing Address - Street 1:8517 LOCH RAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286
Mailing Address - Country:US
Mailing Address - Phone:410-665-8200
Mailing Address - Fax:410-665-2405
Practice Address - Street 1:2014 S TOLLGATE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015
Practice Address - Country:US
Practice Address - Phone:410-569-9202
Practice Address - Fax:410-665-2406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARYLAND ORTHOTICS-PROSTHETICS CO., INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-11
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0156560003Medicare NSC