Organization
ORTHOPAEDIC AND SPORTS MEDICINE CENTER LLC
Active
Parent organization
ORTHOPAEDIC AND SPORTS MEDICINE CENTER LLC
Other names
BOWIE O AND P
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHOPAEDIC AND SPORTS MEDICINE CENTER LLC
Authorized official
DR. STEPHEN E FAUST M.D. (DIRECTOR)
(410) 268-8862
Entity
Organization
Contact information
Practice address
4175 N HANSON CT, SUITE 302, BOWIE, MD 20716-3179
(301) 805-0190
(301) 352-0173
Mailing address
108 FORBES ST, ANNAPOLIS, MD 21401-1502
(410) 268-8862
(410) 268-0380
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
A2505
MD
335E00000X
Prosthetic/Orthotic Supplier
Primary
A2505
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412902400
—
MD
Enumeration date
05/21/2008
Last updated
06/03/2008
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