Provider Demographics
NPI:1568678308
Name:JOHN C. ARRABAL, MD, PA
Entity Type:Organization
Organization Name:JOHN C. ARRABAL, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARRABAL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:410-778-6410
Mailing Address - Street 1:6602 CHURCH HILL RD
Mailing Address - Street 2:STE 500
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620
Mailing Address - Country:US
Mailing Address - Phone:410-778-6410
Mailing Address - Fax:410-778-2144
Practice Address - Street 1:6602 CHURCH HILL RD
Practice Address - Street 2:STE 500
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620
Practice Address - Country:US
Practice Address - Phone:410-778-6410
Practice Address - Fax:410-778-2144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD23889208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD44744Medicare UPIN
MD789LMedicare ID - Type UnspecifiedGROUP NUMBER MEDICARE