Provider Demographics
NPI:1134240401
Name:FALLS MEDICAL SPECIALISTS, LLC
Entity type:Organization
Organization Name:FALLS MEDICAL SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:TEDDY
Authorized Official - Last Name:FINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-583-2828
Mailing Address - Street 1:10753 FALLS RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4535
Mailing Address - Country:US
Mailing Address - Phone:410-583-2828
Mailing Address - Fax:410-583-2841
Practice Address - Street 1:10753 FALLS RD
Practice Address - Street 2:SUITE 225
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4535
Practice Address - Country:US
Practice Address - Phone:410-583-2828
Practice Address - Fax:410-583-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD19914207RR0500X
MDD47373207RR0500X
MDD60427207RR0500X
MDD50592207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH86491Medicare UPIN
MDD76187Medicare UPIN
MDG46069Medicare UPIN
MDG11238Medicare UPIN