# ADV CNTRS FOR ORTHO SURG & SPORTS MED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952315756
- **Authorized official:** MS. JULIANNE RENE SEDA (PRACTICE OPERATIONS LIAISON)
- **Authorized official phone:** (410) 484-8088

## Contact information

- **Practice address:** 10 CROSSROADS DRIVE, SUITE 210, OWINGS MILLS, MD 21117
- **Practice address phone:** (410) 484-8088
- **Practice address fax:** (410) 581-9134
- **Mailing address:** 10 CROSSROADS DRIVE, SUITE 210, OWINGS MILLS, MD 21117
- **Mailing address phone:** (410) 484-8088
- **Mailing address fax:** (410) 581-9134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2006
- **Last updated:** 05/15/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 117856 | KAISER | MD |
| 01 | — | KK05AD | BLUE SHILED | MD |
| 01 | — | W520 | BLUE SHILED | DC |