Provider Demographics
NPI:1689804007
Name:ATLANTIC MED STATS INC
Entity Type:Organization
Organization Name:ATLANTIC MED STATS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-743-7809
Mailing Address - Street 1:841 E FORT AVE
Mailing Address - Street 2:STE 215
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:841 E FORT AVE
Practice Address - Street 2:STE 215
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5117
Practice Address - Country:US
Practice Address - Phone:443-743-7809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD26373207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty