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Organization
ADV CNTRS FOR ORTHO SURG & SPORTS MED
Active
Organization
ADV CNTRS FOR ORTHO SURG & SPORTS MED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIANNE RENE SEDA (PRACTICE OPERATIONS LIAISON)
(410) 484-8088
Entity
Organization
Contact information
Practice address
10 CROSSROADS DRIVE, SUITE 210, OWINGS MILLS, MD 21117
(410) 484-8088
(410) 581-9134
Mailing address
10 CROSSROADS DRIVE, SUITE 210, OWINGS MILLS, MD 21117
(410) 484-8088
(410) 581-9134
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117856
KAISER
MD
01
—
KK05AD
BLUE SHILED
MD
01
—
W520
BLUE SHILED
DC
Enumeration date
07/28/2006
Last updated
05/15/2012
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