Provider Demographics
NPI:1669668943
Name:POOLE ENDOSCOPY CENTER
Entity Type:Organization
Organization Name:POOLE ENDOSCOPY CENTER
Other - Org Name:NEEL KAMAL MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-871-9004
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:BROOKLANDVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21022-0938
Mailing Address - Country:US
Mailing Address - Phone:410-871-9004
Mailing Address - Fax:410-871-9006
Practice Address - Street 1:826 WASHINGTON RD
Practice Address - Street 2:SUITE 218
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5750
Practice Address - Country:US
Practice Address - Phone:410-871-9004
Practice Address - Fax:410-871-9006
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEEL KAMAL MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-19
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1191261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD030ZMedicare PIN
MD21C0001193Medicare Oscar/Certification