Provider Demographics
NPI:1548789324
Name:CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Entity Type:Organization
Organization Name:CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Other - Org Name:MID-MARYLAND MUSCULOSKELETAL INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-637-8712
Mailing Address - Street 1:6707 DEMOCRACY BLVD STE 504
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1166
Mailing Address - Country:US
Mailing Address - Phone:410-778-3445
Mailing Address - Fax:410-778-3702
Practice Address - Street 1:201 TALBOT BLVD
Practice Address - Street 2:SUITE W
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-3000
Practice Address - Country:US
Practice Address - Phone:410-778-3445
Practice Address - Fax:410-778-3702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDAPPLIEDFORMedicaid