Provider Demographics
NPI:1447421649
Name:ARCADIA MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:ARCADIA MEDICAL ASSOCIATES
Other - Org Name:ARCADIA MEDICAL P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:MARCELL
Authorized Official - Last Name:FOLASHADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-546-9544
Mailing Address - Street 1:108 PINE BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7141
Mailing Address - Country:US
Mailing Address - Phone:410-546-9544
Mailing Address - Fax:410-860-0219
Practice Address - Street 1:108 PINE BLUFF RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7141
Practice Address - Country:US
Practice Address - Phone:410-546-9544
Practice Address - Fax:410-860-0219
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARCADIA MEDICAL P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050759174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty