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PRIVIA MEDICAL GROUP LLC NPI 1265989925


NPI Information

NPI: 1265989925
Provider Name: PRIVIA MEDICAL GROUP, LLC

Other Name: CENTER FOR PELVIC PAIN

Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

CLIA Number: 21D1015579

Address:
130 LUBRANO DR
SUITE 111
ANNAPOLIS, MD
ZIP 21401
Phone: (410) 573-1436
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PRIVIA MEDICAL GROUP, LLC is a gynecology obstetrics gynecology in Annapolis, MD. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee PRIVIA MEDICAL GROUP, LLC NPI is 1265989925. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Center For Pelvic Pain.

The provider's business location address is:

130 LUBRANO DR
SUITE 111
ANNAPOLIS, MD
ZIP 21401-038
Phone: (410) 573-1436

The provider's authorized official is Maureen Clancy .
The authorized official title is Senior Vice President and has the following contact phone number (571) 982-6636.

The CLIA number assigned to this NPI record is 21D1015579 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/9/2016 and was last updated on 3/5/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VG0400XObstetrics & GynecologyGynecologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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