Provider Demographics
NPI:1730129594
Name:ATLANTIC PHYSICIAN SERVICES OF MARYLAND, P.C.
Entity Type:Organization
Organization Name:ATLANTIC PHYSICIAN SERVICES OF MARYLAND, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-848-3817
Mailing Address - Street 1:PO BOX 634994
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5023
Mailing Address - Country:US
Mailing Address - Phone:856-686-4316
Mailing Address - Fax:
Practice Address - Street 1:701 N CLAYTON ST.
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-0000
Practice Address - Country:US
Practice Address - Phone:856-686-4316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW7Z571OtherNY EMPIRE MEDICARE
DE1730129594Medicaid
DEG00178Medicare PIN
PA108233Medicare PIN
NYW7Z571OtherNY EMPIRE MEDICARE
PA065062Medicare PIN
MD683LMedicare PIN