Organization
INFECTIOUS DISEASE ASSOCIATES, P.A.
Active
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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