Organization
INFECTIOUS DISEASE ASSOCIATES, P.A.
Active
Other names
B. MARK LANDRUM, M.D., P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN MARK LANDRUM M.D. (PRESIDENT)
(410) 418-8550
Entity
Organization
Contact information
Practice address
2850 N RIDGE RD, SUITE 203, ELLICOTT CITY, MD 21043-3464
(410) 418-8550
(410) 418-8552
Mailing address
PO BOX 2377, ELLICOTT CITY, MD 21041-2377
(410) 418-8550
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
D0057970
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402077400
—
MD
01
—
DA5812
RAILROAD MEDICARE GROUP #
MD
01
—
G972
BLUECHOICE MARYLAND GRP #
MD
01
—
KES7IN
CAREFIRST, MARYLAND GRP #
MD
Enumeration date
08/16/2006
Last updated
03/01/2011
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