Provider Demographics
NPI:1396561098
Name:UNIVERSITY OF MARYLAND ORTHOPAEDIC ASSOCIATES, PA
Entity type:Organization
Organization Name:UNIVERSITY OF MARYLAND ORTHOPAEDIC ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROFESSIONAL FEES
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:GODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-214-2732
Mailing Address - Street 1:2200 KERNAN DR STE 1154
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-6665
Mailing Address - Country:US
Mailing Address - Phone:667-214-2732
Mailing Address - Fax:
Practice Address - Street 1:1000 HILLTOP CIR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21250-0001
Practice Address - Country:US
Practice Address - Phone:410-448-6400
Practice Address - Fax:410-448-6296
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF MARYLAND ORTHOPAEDIC ASSOCIATES, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty