Provider Demographics
NPI:1326305053
Name:ADVANCED MEDICINE, INC
Entity Type:Organization
Organization Name:ADVANCED MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:T
Authorized Official - Last Name:WENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-339-3850
Mailing Address - Street 1:1407 YORK RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6097
Mailing Address - Country:US
Mailing Address - Phone:410-339-3850
Mailing Address - Fax:410-339-3852
Practice Address - Street 1:1407 YORK RD
Practice Address - Street 2:SUITE 307
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6097
Practice Address - Country:US
Practice Address - Phone:410-339-3850
Practice Address - Fax:410-339-3852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD518RMedicare PIN