Provider Demographics
NPI:1508585076
Name:MID-ATLANTIC PSYCHIATRY LLC
Entity Type:Organization
Organization Name:MID-ATLANTIC PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-707-1025
Mailing Address - Street 1:6288 BELMONT CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-8037
Mailing Address - Country:US
Mailing Address - Phone:410-707-1025
Mailing Address - Fax:
Practice Address - Street 1:6288 BELMONT CIR
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-8037
Practice Address - Country:US
Practice Address - Phone:410-707-1025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty