Basic Information
| Provider Information | |||||||||
| NPI: | 1700256559 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DIMENSIONS HEALTHCARE ASSOCIATES, INC | ||||||||
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| OtherOrganizationName: | PGHC TRAUMA ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3001 HOSPITAL DR | ||||||||
| Address2: | DHA BILLING OFFICE | ||||||||
| City: | CHEVERLY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207851189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016183368 | ||||||||
| FaxNumber: | 3016183521 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 MERCY LN | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | CHEVERLY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207851157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016181550 | ||||||||
| FaxNumber: | 3014291873 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2015 | ||||||||
| LastUpdateDate: | 10/05/2015 | ||||||||
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| AuthorizedOfficialLastName: | TWADDLE | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3016183615 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0127X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.