Provider Demographics
NPI:1750784294
Name:ORTHOPEDIC PHYSICIANS OF ANNAPOLIS,LLC
Entity type:Organization
Organization Name:ORTHOPEDIC PHYSICIANS OF ANNAPOLIS,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:VERKLIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:410-295-8900
Mailing Address - Street 1:2000 MEDICAL PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3742
Mailing Address - Country:US
Mailing Address - Phone:410-268-8862
Mailing Address - Fax:410-280-4701
Practice Address - Street 1:8109 RITCHIE HWY
Practice Address - Street 2:STE 200
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-6917
Practice Address - Country:US
Practice Address - Phone:410-268-8862
Practice Address - Fax:410-280-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-29
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
6244460005Medicare NSC