Provider Demographics
NPI:1861857484
Name:COLUMBIA MEDICS INC
Entity Type:Organization
Organization Name:COLUMBIA MEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SESHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ADUSUMILLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-355-4680
Mailing Address - Street 1:10615 OLD ELLICOTT CIR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2199
Mailing Address - Country:US
Mailing Address - Phone:443-355-4680
Mailing Address - Fax:208-723-5911
Practice Address - Street 1:10615 OLD ELLICOTT CIR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2199
Practice Address - Country:US
Practice Address - Phone:443-355-4680
Practice Address - Fax:208-723-5911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-25
Last Update Date:2015-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0073685207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty