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MID-ATLANTIC ENT LLC NPI 1770175978


NPI Information

NPI: 1770175978
Provider Name: MID-ATLANTIC ENT, LLC

Doing Business As: ANNE ARUNDEL ENT & FACIAL PLASTIC SURGERY

Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 21D2260845

Address:
600 RIDGELY AVE STE 110
ANNAPOLIS, MD
ZIP 21401
Phone: (410) 573-9191
Get Directions

MID-ATLANTIC ENT, LLC is an otolaryngology in Annapolis, MD. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. MID-ATLANTIC ENT, LLC NPI is 1770175978. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Anne Arundel Ent & Facial Plastic Surgery.

The provider's business location address is:

600 RIDGELY AVE STE 110
ANNAPOLIS, MD
ZIP 21401-082
Phone: (410) 573-9191
Fax: (410) 573-5910

The provider's authorized official is Lee Allan Kleiman .
The authorized official title is Medical Director and has the following contact phone number (410) 573-9191.

The CLIA number assigned to this NPI record is 21D2260845 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/9/2021 and was last updated on 10/10/2022.


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
1207YX0007XOtolaryngologyPlastic Surgery within the Head & NeckNo
2207YX0905XOtolaryngologyOtolaryngology/Facial Plastic SurgeryNo
3207Y00000XOtolaryngologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1502528100MEDICAIDMARYLAND
2FN66-0000OTHERCAREFIRST BCBS
39001272OTHERMARYLANDAETNA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.