GREGORY MAURICE BAZEMORE NPI 1558849034

NPI Information

NPI: 1558849034
Provider Name: GREGORY MAURICE BAZEMORE
Classification: Specialist - 1744P3200X
Specialization: Prosthetics Case Management
Entity Type: Individual
Address: 3504 LESLIE AVE
TEMPLE HILLS, MD
ZIP 20748
Phone: (703) 955-2567

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NPI Details

Gregory Maurice Bazemore is a prosthetics case management specialist in Temple Hills, MD. The provider is Under the Other Service Providers; Specialist the Prosthetics Case Management definition changed to: A case manager who provides services for patients with prosthetics. Gregory Maurice Bazemore NPI is 1558849034. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3504 LESLIE AVE
TEMPLE HILLS, MD
ZIP 20748-634
Phone: (703) 955-2567

The enumeration date for this NPI number is 8/6/2018 and was last updated on 8/6/2018.

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	1744P3200X	Specialist	Prosthetics Case Management			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	83-1473231	OTHER	MARYLAND	HAIR LOSS PRACTITIONER
2	83-1473231	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: 11/21/2025

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