Provider Demographics
NPI:1437159381
Name:PROFESSIONAL DIAGNOSTICS, LLC
Entity type:Organization
Organization Name:PROFESSIONAL DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SZUMEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-459-3113
Mailing Address - Street 1:106 BOW ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5544
Mailing Address - Country:US
Mailing Address - Phone:610-459-3113
Mailing Address - Fax:
Practice Address - Street 1:106 BOW ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5544
Practice Address - Country:US
Practice Address - Phone:610-459-3113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty