Provider Demographics
NPI:1932312501
Name:ARUNDEL PHYSICIANS ASSOCIATES LAB
Entity Type:Organization
Organization Name:ARUNDEL PHYSICIANS ASSOCIATES LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BAHADOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOMENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-729-2400
Mailing Address - Street 1:8601 VETERANS HWY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108
Mailing Address - Country:US
Mailing Address - Phone:410-729-2400
Mailing Address - Fax:410-729-2404
Practice Address - Street 1:8601 VETERANS HWY
Practice Address - Street 2:SUITE 211
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108
Practice Address - Country:US
Practice Address - Phone:410-729-2400
Practice Address - Fax:410-729-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1379291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCE9203OtherMEDICARE RAILROAD
MDCE9203Medicare PIN
MDCE9203OtherMEDICARE RAILROAD
MDP00458380Medicare PIN
MD049FMedicare PIN