Organization
ANTONIADES SPINE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SPIRO BASIL ANTONIADES M.D. (SOLE PROPRIETOR)
(410) 446-8747
Entity
Organization
Contact information
Practice address
2014 S TOLLGATE RD STE 107, BEL AIR, MD 21015-6010
(410) 466-8747
(443) 643-2088
Mailing address
PO BOX 626, GREAT RIVER, NY 11739-0626
(631) 907-2186
(631) 201-3179
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
D0047688
MD
Other
Enumeration date
05/16/2008
Last updated
06/02/2021
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