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MARYLAND SPORTS SPINE AND MUSCULOSKELETAL INSTITUTE NPI 1528586948


NPI Information

NPI: 1528586948
Provider Name: MARYLAND SPORTS, SPINE AND MUSCULOSKELETAL INSTITUTE

Doing Business As: MSSMI

Classification: Physical Medicine & Rehabilitation - 2081S0010X
Entity Type: Organization

Specialization: Sports Medicine

CLIA Number: 21D0215646

Address:
8096 EDWIN RAYNOR BLVD STE C
PASADENA, MD
ZIP 21122
Phone: (240) 460-4661
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MARYLAND SPORTS, SPINE AND MUSCULOSKELETAL INSTITUTE is a sports medicine physical medicine rehabilitation in Pasadena, MD. The provider is a physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. MARYLAND SPORTS, SPINE AND MUSCULOSKELETAL INSTITUTE NPI is 1528586948. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Mssmi.

The provider's business location address is:

8096 EDWIN RAYNOR BLVD STE C
PASADENA, MD
ZIP 21122-837
Phone: (240) 460-4661

The provider's authorized official is Justin Waltrous .
The authorized official title is Owner and has the following contact phone number (240) 460-4661.

The CLIA number assigned to this NPI record is 21D0215646 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

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


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
12081S0010XPhysical Medicine & RehabilitationSports MedicineD0077249MARYLANDYes

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

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