Basic Information
| Provider Information | |||||||||
| NPI: | 1205854767 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREATER METROPOLITAN ORTHOPAEDICS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8926 WOODYARD RD | ||||||||
| Address2: | SUITE 701 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207354220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018561682 | ||||||||
| FaxNumber: | 3018560964 | ||||||||
| Practice Location | |||||||||
| Address1: | 8926 WOODYARD RD | ||||||||
| Address2: | SUITE 701 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207354220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018561682 | ||||||||
| FaxNumber: | 3018560964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 11/07/2012 | ||||||||
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| AuthorizedOfficialLastName: | SABLOFF | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3018561682 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2081P2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | 207XX0004X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery | 207XX0005X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207XS0117X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | 363AS0400X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 207RR0500X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 225X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2491418 | 01 | AETNA GROUP PROVIDER # VIRGINIA LOCATION | OTHER | 1205140639 | 01 | LORTON VIRGINIA LOCATION NPI | OTHER | 1801102504 | 01 | WALDORF MARYLAND LOCATION NPI | OTHER | 2803674 | 01 | AETNA GROUP PROVIDER # WALDORF LOCATION | OTHER | S176 | 01 | MD | BCBS MD GRP PROVIDER# | OTHER | 1194039511 | 01 | SPRINGFIELD VIRGINIA LOCATION NPI | OTHER | 145530100 | 01 | DEPARTMENT OF LABOR PROV# | OTHER | 1548576242 | 01 | ALEXANDRIA VIRGINIA LOCATION NPI | OTHER | 21D1105636 | 01 | CLIA NUMBER | OTHER | CI2264 | 01 | RAILROAD MEDICARE PTAN | OTHER | 0254450001 | 01 | MEDICARE NSC | OTHER | 0455415 | 01 | AETNA GROUP PROVIDER # CLINTON LOCATION | OTHER | DG8302 | 01 | MD | RAILROAD MEDICARE | OTHER | 4695 | 01 | DC | BCBS NCA GRP PROV# | OTHER | 712403 | 01 | UNITED HEALTH CARE/MAMSI GROUP PROVIDER# | OTHER | 1184930885 | 01 | CLINTON MARYLAND LOCATION NPI | OTHER | 1942514450 | 01 | MOUNT VERNON VIRGINIA LOCATION NPI | OTHER |