Provider Demographics
NPI:1972740777
Name:THE ORTHOPAEDIC GROUP LLC
Entity type:Organization
Organization Name:THE ORTHOPAEDIC GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPICER
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:301-599-1000
Mailing Address - Street 1:9135 PISCATAWAY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2549
Mailing Address - Country:US
Mailing Address - Phone:301-599-1000
Mailing Address - Fax:301-856-7685
Practice Address - Street 1:9135 PISCATAWAY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2549
Practice Address - Country:US
Practice Address - Phone:301-599-1000
Practice Address - Fax:301-856-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100036199474483174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty