Provider Demographics
NPI:1710147608
Name:GREATER METROPOLITAN ORTHOPAEDICS
Entity Type:Organization
Organization Name:GREATER METROPOLITAN ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHNEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-856-1682
Mailing Address - Street 1:8926 WOODYARD RD
Mailing Address - Street 2:SUITE 701
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4220
Mailing Address - Country:US
Mailing Address - Phone:301-856-1682
Mailing Address - Fax:
Practice Address - Street 1:11325 PEMBROOKE SQUARE
Practice Address - Street 2:SUITE 115
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603
Practice Address - Country:US
Practice Address - Phone:301-719-1167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20891225100000X
MD20764225100000X
VA2305006484225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4695OtherCAREFIRST BCBS NCA
145530100OtherDOL
176608OtherMETRO MEDICARE
462LOtherMARYLAND MEDICARE
S176OtherCAREFIRST OF MARYLAND
DG8302OtherRAILROAD MEDICARE
0254450001Medicare NSC