Provider Demographics
NPI:1841703220
Name:METROPOLITAN NEUROLOGICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:METROPOLITAN NEUROLOGICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GURDEEP
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:AHLUWALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-937-2445
Mailing Address - Street 1:11219 INDEPENDENCE WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1505
Mailing Address - Country:US
Mailing Address - Phone:301-520-1962
Mailing Address - Fax:443-716-0419
Practice Address - Street 1:122 DEFENSE HWY STE 222
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7071
Practice Address - Country:US
Practice Address - Phone:443-716-0420
Practice Address - Fax:443-716-0419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD014011200Medicaid