Provider Demographics
NPI:1568508273
Name:CHIARMAMONTE HUISMAN ZORN UROLOGY LLC
Entity Type:Organization
Organization Name:CHIARMAMONTE HUISMAN ZORN UROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-645-7735
Mailing Address - Street 1:7501 SURRATTS RD STE 308
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3377
Mailing Address - Country:US
Mailing Address - Phone:301-868-0202
Mailing Address - Fax:301-868-2331
Practice Address - Street 1:7501 SURRATTS RD STE 308
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3362
Practice Address - Country:US
Practice Address - Phone:301-868-0202
Practice Address - Fax:301-868-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5164990001Medicare NSC