Provider Demographics
NPI:1790032365
Name:ORTHOPAEDIC CARE ASSOCIATES, PA
Entity Type:Organization
Organization Name:ORTHOPAEDIC CARE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-445-4800
Mailing Address - Street 1:12501 PROSPERITY DR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1689
Mailing Address - Country:US
Mailing Address - Phone:301-445-4800
Mailing Address - Fax:301-755-5027
Practice Address - Street 1:12501 PROSPERITY DR
Practice Address - Street 2:SUITE 330
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1689
Practice Address - Country:US
Practice Address - Phone:301-445-4800
Practice Address - Fax:301-755-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033963207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty