Organization
BRIGHTSEAT HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRIE L BALLENGER (ADMINISTRATOR)
(301) 398-6090
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
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326052051
NPI
MD
01
—
1417023128
NPI
MD
01
—
1861473555
NPI
MD
Enumeration date
06/07/2011
Last updated
06/07/2011
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