Provider Demographics
NPI:1326148347
Name:MARYLAND PERINATAL ASSOCIATES
Entity Type:Organization
Organization Name:MARYLAND PERINATAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:B
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-251-8611
Mailing Address - Street 1:15005 SHADY GROVE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6340
Mailing Address - Country:US
Mailing Address - Phone:301-251-8611
Mailing Address - Fax:301-251-8779
Practice Address - Street 1:15005 SHADY GROVE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6340
Practice Address - Country:US
Practice Address - Phone:301-251-8611
Practice Address - Fax:301-251-8779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050638207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
197CMAOtherBCBS MARYLAND
K785OtherBCBS DC
MD0706806OtherAMERICHOICE
MD254856OtherKAISER
MD409486700Medicaid
MD0706806OtherAMERICHOICE