Provider Demographics
NPI:1346279262
Name:MEDPRO HOSPITALISTS LLP
Entity Type:Organization
Organization Name:MEDPRO HOSPITALISTS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELSON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FIGARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-618-6011
Mailing Address - Street 1:12700 GOODLOES PROMISE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4624
Mailing Address - Country:US
Mailing Address - Phone:301-805-4218
Mailing Address - Fax:301-805-8147
Practice Address - Street 1:3001 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1189
Practice Address - Country:US
Practice Address - Phone:301-618-6011
Practice Address - Fax:301-618-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCJ443OtherCAREFIRST BLUE SHEILD
DC035540600Medicaid
MD494AMEOtherCAREFIRST BLUE SHEILD
MD393057OtherMAMSI LIFE & HEALTH
MDDB3137OtherRAIL ROAD MEDICARE
MDDB3137OtherRAIL ROAD MEDICARE