MID-MARYLAND ORAL AND MAXILLOFACIAL SURGERY PA NPI 1710950399

NPI Information

  • NPI: 1710950399
  • Provider Name: MID-MARYLAND ORAL AND MAXILLOFACIAL SURGERY PA
  • Classification: Clinic/Center - 261QS0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 68 THOMAS JOHNSON DR
    SUITE A
    FREDERICK, MD
    ZIP 21702
  • Phone: (301) 694-2300

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NPI Details

MID-MARYLAND ORAL AND MAXILLOFACIAL SURGERY PA is an oral and maxillofacial surgery clinic center in Frederick, MD. The provider is an oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. MID-MARYLAND ORAL AND MAXILLOFACIAL SURGERY PA NPI is 1710950399. The provider is registered as an organization entity type.

The provider's business location address is:

68 THOMAS JOHNSON DR
SUITE A
FREDERICK, MD
ZIP 21702
Phone: (301) 694-2300
Fax: (301) 694-7372

The provider's authorized official is Peter M Tan .
The authorized official title is President and has the following contact phone number (301) 694-2300.

The enumeration date for this NPI number is 2/13/2006 and was last updated on 7/21/2010.

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
1261QS0112XClinic/CenterOral and Maxillofacial SurgeryYes

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
1733LMEDICARE PIN

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: 3/30/2025

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