# MARYLAND IVF FERTILITY HEALTH & WELLNESS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MARYLAND IVF
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427380302
- **Authorized official:** DR. DIANA P BROOMFIELD M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (410) 964-2229

## Contact information

- **Practice address:** 11055 LITTLE PATUXENT PKWY, COLUMBIA, MD 21044-2896
- **Practice address phone:** (410) 964-2229
- **Practice address fax:** (410) 964-0009
- **Mailing address:** 9250 BENDIX RD, COLUMBIA, MD 21045-1832
- **Mailing address phone:** (410) 964-2229
- **Mailing address fax:** (410) 964-0009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0100X | Health Service Clinic/Center | MD034987 | DC | — |
| 261QM2500X | Medical Specialty Clinic/Center | 0101234644 | VA | — |
| 261QM2500X | Medical Specialty Clinic/Center | D0060312 | MD | Yes |

## Other

- **Enumeration date:** 02/03/2010
- **Last updated:** 02/03/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 114403690265 | NPI | MD |