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Organization

BRIGHTSEAT SPECIALIST CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERRIE L BALLENGER (ADMINISTRATOR)
(301) 386-6090
Entity
Organization

Contact information

Practice address
1827 BRIGHTSEAT RD, LANDOVER, MD 20785-4250
(301) 386-6090
Mailing address
1827 BRIGHTSEAT RD, LANDOVER, MD 20785-4250
(301) 386-6090

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
207X00000X
Orthopaedic Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013094317
NPI
MD
01
1306837034
NPI
MD
01
1821141292
NPI
MD
Enumeration date
06/07/2011
Last updated
06/07/2011
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