Basic Information
| Provider Information | |||||||||
| NPI: | 1790296200 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SKY PHYSICIANS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20010 CENTURY BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208741118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2406862300 | ||||||||
| FaxNumber: | 2406862330 | ||||||||
| Practice Location | |||||||||
| Address1: | 20010 CENTURY BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208741118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2406862300 | ||||||||
| FaxNumber: | 2406862330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2017 | ||||||||
| LastUpdateDate: | 10/24/2017 | ||||||||
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| AuthorizedOfficialLastName: | ADELMAN | ||||||||
| AuthorizedOfficialFirstName: | LEON | ||||||||
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| AuthorizedOfficialTitleorPosition: | TEAM LEADERSHIP | ||||||||
| AuthorizedOfficialTelephone: | 2406862300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.