Provider Demographics
NPI:1568046837
Name:COMPREHENSIVE MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL SERVICES, LLC
Other - Org Name:COMPREHENSIVE MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ASHELY COLLIS
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-861-2971
Mailing Address - Street 1:3801 CANTERBURY RD UNIT 711
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2376
Mailing Address - Country:US
Mailing Address - Phone:202-861-2971
Mailing Address - Fax:
Practice Address - Street 1:3801 CANTERBURY RD UNIT 711
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2376
Practice Address - Country:US
Practice Address - Phone:202-861-2971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086H0002XAllopathic & Osteopathic PhysiciansSurgeryHospice and Palliative MedicineGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty