Provider Demographics
NPI:1568600807
Name:TWOMEY, MICHAEL R (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:TWOMEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9946 OAK LEA CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3638
Mailing Address - Country:US
Mailing Address - Phone:410-330-9380
Mailing Address - Fax:410-580-1505
Practice Address - Street 1:8116 GOOD LUCK RD STE 205
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3508
Practice Address - Country:US
Practice Address - Phone:301-552-4284
Practice Address - Fax:301-599-9500
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-24
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17752225100000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist