Provider Demographics
NPI:1700256559
Name:DIMENSIONS HEALTHCARE ASSOCIATES, INC
Entity Type:Organization
Organization Name:DIMENSIONS HEALTHCARE ASSOCIATES, INC
Other - Org Name:PGHC TRAUMA ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TWADDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-618-3615
Mailing Address - Street 1:3001 HOSPITAL DR
Mailing Address - Street 2:DHA BILLING OFFICE
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1189
Mailing Address - Country:US
Mailing Address - Phone:301-618-3368
Mailing Address - Fax:301-618-3521
Practice Address - Street 1:2900 MERCY LN
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1157
Practice Address - Country:US
Practice Address - Phone:301-618-1550
Practice Address - Fax:301-429-1873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD024030Medicare PIN