Organization
MIDDLETOWN VALLEY FAMILY MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER M RAITHEL (PRACTICE ADMINISTRATOR)
(301) 371-9000
Entity
Organization
Contact information
Practice address
300 S CHURCH ST, MIDDLETOWN, MD 21769-8043
(301) 371-9000
(301) 371-8905
Mailing address
300 S CHURCH ST, MIDDLETOWN, MD 21769-8043
(301) 371-9000
(301) 371-8905
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
913961300
—
MD
01
—
H569
BCBS GROUP NUMBER
MD
01
—
H931
BCBS DC GROUP #
MD
Enumeration date
12/07/2005
Last updated
09/17/2009
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