Provider Demographics
NPI:1700948205
Name:EASTERN SHORE ORTHOPAEDICS
Entity Type:Organization
Organization Name:EASTERN SHORE ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ADRIGNOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-677-0725
Mailing Address - Street 1:106 PINE BLUFF RD
Mailing Address - Street 2:SUITE 16
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7161
Mailing Address - Country:US
Mailing Address - Phone:410-677-0725
Mailing Address - Fax:410-677-3077
Practice Address - Street 1:106 PINE BLUFF RD
Practice Address - Street 2:SUITE 16
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7161
Practice Address - Country:US
Practice Address - Phone:410-677-0725
Practice Address - Fax:410-677-3077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
747MMedicare PIN