Provider Demographics
NPI:1346219359
Name:ARUNDEL NEUROLOGY, P.A.
Entity Type:Organization
Organization Name:ARUNDEL NEUROLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SYME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-451-9064
Mailing Address - Street 1:PO BOX 64023
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4023
Mailing Address - Country:US
Mailing Address - Phone:410-280-6538
Mailing Address - Fax:
Practice Address - Street 1:2401 BRANDERMILL BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1690
Practice Address - Country:US
Practice Address - Phone:410-451-9064
Practice Address - Fax:410-451-9065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD302MMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER