Provider Demographics
NPI:1952739500
Name:PARTNERMD MARYLAND PC
Entity Type:Organization
Organization Name:PARTNERMD MARYLAND PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MUMPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-282-2655
Mailing Address - Street 1:9 PARK CENTER CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5623
Mailing Address - Country:US
Mailing Address - Phone:804-282-2655
Mailing Address - Fax:804-672-4948
Practice Address - Street 1:9 PARK CENTER CT
Practice Address - Street 2:SUITE 200
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5623
Practice Address - Country:US
Practice Address - Phone:804-282-2655
Practice Address - Fax:804-672-4948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty