Provider Demographics
NPI:1356544779
Name:MEDICAL REVIEW ORGANIZATION PA
Entity type:Organization
Organization Name:MEDICAL REVIEW ORGANIZATION PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:ONEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-589-7441
Mailing Address - Street 1:9709 STONEYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3146
Mailing Address - Country:US
Mailing Address - Phone:301-589-7441
Mailing Address - Fax:301-495-8991
Practice Address - Street 1:9709 STONEYBROOK DR
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3146
Practice Address - Country:US
Practice Address - Phone:301-589-7441
Practice Address - Fax:301-495-8991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0043745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC3138OtherBCBS DC
MD74NSJKOtherBCBS MD
MD5476448OtherAETNA
MDG01751Medicare PIN
MDY23066Medicare UPIN