Provider Demographics
NPI:1801004007
Name:COVINGTON, MAGGIE BURDETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGGIE
Middle Name:BURDETTE
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MAGGIE
Other - Middle Name:COVINGTON
Other - Last Name:CORNWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11029 DORSCH FARM RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-6267
Mailing Address - Country:US
Mailing Address - Phone:410-884-0303
Mailing Address - Fax:
Practice Address - Street 1:9145 GUILFORD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1883
Practice Address - Country:US
Practice Address - Phone:410-880-4215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0036995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE30175Medicare UPIN