Provider Demographics
NPI:1821271032
Name:MARYLAND ONCOLOGY HEMATOLOGY, P.A.
Entity type:Organization
Organization Name:MARYLAND ONCOLOGY HEMATOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-909-3301
Mailing Address - Street 1:11720 BELTSVILLE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3119
Mailing Address - Country:US
Mailing Address - Phone:240-223-1893
Mailing Address - Fax:301-326-2926
Practice Address - Street 1:7350 VAN DUSEN RD STE 370
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5231
Practice Address - Country:US
Practice Address - Phone:301-470-1001
Practice Address - Fax:301-470-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDR6644OtherMEDICARE RAILROAD PTAN
MD215868OtherMEDICARE PTAN