Provider Demographics
NPI:1255401154
Name:MEDICAL MANAGEMENT SPECIALISTS, INC.
Entity type:Organization
Organization Name:MEDICAL MANAGEMENT SPECIALISTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-725-5050
Mailing Address - Street 1:8106 D-STAYTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-0934
Mailing Address - Country:US
Mailing Address - Phone:301-725-5050
Mailing Address - Fax:301-725-5111
Practice Address - Street 1:8106 D-STAYTON DRIVE
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-0934
Practice Address - Country:US
Practice Address - Phone:301-725-5050
Practice Address - Fax:301-725-5111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0027184261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0027184OtherSTATE LICENSE NUMBER