Basic Information
| Provider Information | |||||||||
| NPI: | 1336179175 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARUNDEL HEART ASSOCIATES, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7845 OAKWOOD RD | ||||||||
| Address2: | STE 106 | ||||||||
| City: | GLEN BURNIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210614280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107605100 | ||||||||
| FaxNumber: | 4107605932 | ||||||||
| Practice Location | |||||||||
| Address1: | 7845 OAKWOOD RD | ||||||||
| Address2: | STE 106 | ||||||||
| City: | GLEN BURNIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210614280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107605100 | ||||||||
| FaxNumber: | 4107605932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 11/06/2007 | ||||||||
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| AuthorizedOfficialLastName: | BREWER | ||||||||
| AuthorizedOfficialFirstName: | NANCY | ||||||||
| AuthorizedOfficialMiddleName: | L. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4107605100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.