Provider Demographics
NPI:1720479728
Name:OCCUPATIONAL HEALTH & ADDICTION SERVICES OF HOWARD COUNTY
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH & ADDICTION SERVICES OF HOWARD COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVESH
Authorized Official - Middle Name:DHRUVA
Authorized Official - Last Name:KANJARPANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH FACPM
Authorized Official - Phone:301-675-1296
Mailing Address - Street 1:6041 WINTER GRAIN PATH
Mailing Address - Street 2:STE # 1H
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1224
Mailing Address - Country:US
Mailing Address - Phone:301-675-1296
Mailing Address - Fax:443-535-0773
Practice Address - Street 1:4807 BENSON AVE
Practice Address - Street 2:STE # 101
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-1530
Practice Address - Country:US
Practice Address - Phone:443-524-2737
Practice Address - Fax:443-524-2742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD40076207QA0401X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty