Basic Information
| Provider Information | |||||||||
| NPI: | 1861050619 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORTHOPEDIC PHYSICIANS OF ANNAPOLIS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12522 | ||||||||
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| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434818862 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1630 MAIN ST STE 101 | ||||||||
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| City: | CHESTER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216192792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102688862 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2019 | ||||||||
| LastUpdateDate: | 06/05/2019 | ||||||||
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| AuthorizedOfficialLastName: | ANSARI | ||||||||
| AuthorizedOfficialFirstName: | ZUBAIR | ||||||||
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| AuthorizedOfficialTitleorPosition: | EX DIR PHYSICIAN REIMBURSEMENT | ||||||||
| AuthorizedOfficialTelephone: | 4434816521 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.