Basic Information
Provider Information
NPI: 1730482449
EntityType: 2
ReplacementNPI:  
OrganizationName: JMH EMERGENCY PHYSICIANS
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: 2406862330
Practice Location
Address1: 300 S PRESTON ST
Address2:  
City: RANSON
State: WV
PostalCode: 254381631
CountryCode: US
TelephoneNumber: 2406862300
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/20/2010
LastUpdateDate: 09/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CHARLEY
AuthorizedOfficialFirstName: AMY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF LEGAL OFFICE
AuthorizedOfficialTelephone: 2406862300
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: ESQ
NPICertificationDate: 09/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


Home