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Organization
MID ATLANTIC SPINE & ORTHOPAEDICS, LLC
Active
Organization
MID ATLANTIC SPINE & ORTHOPAEDICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY F DAVIS M.D. (OWNER)
(410) 553-8290
Entity
Organization
Contact information
Practice address
305 HOSPITAL DR, SUITE 303, GLEN BURNIE, MD 21061-5805
(410) 553-8290
Mailing address
305 HOSPITAL DR, SUITE 303, GLEN BURNIE, MD 21061-5805
(410) 553-8290
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
D0024332
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K894
CAPITAL BLUE CROSS
MD
Enumeration date
06/11/2007
Last updated
08/22/2020
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