Basic Information
| Provider Information | |||||||||
| NPI: | 1235308479 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ADVANCED CENTERS FOR ORTHOPEDIC SURGERY AND SPORTS MEDICINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 759190 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212759190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104848088 | ||||||||
| FaxNumber: | 4105819134 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 CROSSROADS DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | OWINGS MILLS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211175458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104848088 | ||||||||
| FaxNumber: | 4105819134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2008 | ||||||||
| LastUpdateDate: | 02/21/2008 | ||||||||
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| AuthorizedOfficialLastName: | PALIATH | ||||||||
| AuthorizedOfficialFirstName: | SEBASTIAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4104848088 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ADVANCED CENTERS FOR ORTHOPEDIC SURGERY AND SPORTS MEDICIANE | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.