Organization
MARCOS S FALTAMO CRNA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCOS S FALTAMO CRNA (PRESIDENT)
(301) 317-0020
Entity
Organization
Contact information
Practice address
1300 MERCANTILE LN, LARGO, MD 20774-5327
(301) 317-0020
(301) 317-0028
Mailing address
3640 LYONS CREEK ROAD, DUNKIRK, MD 20754-4000
(301) 317-0020
(301) 317-0028
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R143174
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
358CMA
MD CAREFIRST
—
05
—
631900900
—
MD
01
—
DE4370
RAILROAD MEDICARE
GA
01
—
G02224
MEDICARE PIN
DC
01
—
K947
DC CAREFIRST
—
Enumeration date
02/04/2008
Last updated
04/30/2008
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