Provider Demographics
NPI:1134244809
Name:METROPOLITAN OBGYN ASSOCIATES,LLC
Entity type:Organization
Organization Name:METROPOLITAN OBGYN ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-415-5577
Mailing Address - Street 1:1838 GREENE TREE RD
Mailing Address - Street 2:SUITE 380
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6391
Mailing Address - Country:US
Mailing Address - Phone:410-415-5577
Mailing Address - Fax:410-415-6682
Practice Address - Street 1:934 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3940
Practice Address - Country:US
Practice Address - Phone:410-523-4700
Practice Address - Fax:410-383-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKM21Medicare ID - Type Unspecified