PROVIDENCE HEALTH SERVICES NPI 1194985515

NPI Information

NPI: 1194985515
Provider Name: PROVIDENCE HEALTH SERVICES
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
4151 BLADENSBURG RD
COLMAR MANOR, MD
ZIP 20722
Phone: (301) 699-7700
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PROVIDENCE HEALTH SERVICES is a family medicine in Colmar Manor, MD. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROVIDENCE HEALTH SERVICES NPI is 1194985515. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4151 BLADENSBURG RD
COLMAR MANOR, MD
ZIP 20722-928
Phone: (301) 699-7700
Fax: (301) 779-9001

The provider's authorized official is Timothy Sheridan .
The authorized official title is Assistant Vp, Practice Mgt Services and has the following contact phone number (202) 269-7374.

The enumeration date for this NPI number is 6/10/2008 and was last updated on 10/9/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		HFD01-0212	DISTRICT OF COLUMBIA	No
2	207Q00000X	Family Medicine		HFD01-0212	DISTRICT OF COLUMBIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	548521501	MEDICAID	MARYLAND

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: 5/5/2024

NPI Synchronization or Removal

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