Basic Information
Provider Information
NPI: 1154749158
EntityType: 2
ReplacementNPI:  
OrganizationName: METROPOLITAN PATIENT SERVICES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12420 MILESTONE CENTER DR STE 200
Address2:  
City: GERMANTOWN
State: MD
PostalCode: 208767111
CountryCode: US
TelephoneNumber: 2406862300
FaxNumber:  
Practice Location
Address1: 8118 GOOD LUCK RD
Address2:  
City: LANHAM
State: MD
PostalCode: 207063574
CountryCode: US
TelephoneNumber: 2406862300
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/07/2014
LastUpdateDate: 08/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CHARLEY
AuthorizedOfficialFirstName: AMY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP LEGAL
AuthorizedOfficialTelephone: 2046862300
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: ESQ
NPICertificationDate: 08/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansHospitalist 
261QM1300X  N Ambulatory Health Care FacilitiesClinic/CenterMulti-Specialty
207P00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


Home