Basic Information
Provider Information
NPI: 1881987147
EntityType: 2
ReplacementNPI:  
OrganizationName: ORTHOPAEDIC ASSOCIATES OF CENTRAL MD, PA
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5961 EXCHANGE DRIVE
Address2: SUITE 100
City: ELDERSBURG
State: MD
PostalCode: 21784
CountryCode: US
TelephoneNumber: 4106441880
FaxNumber: 4106446048
Practice Location
Address1: 5961 EXCHANGE DRIVE
Address2: SUITE 100
City: ELDERSBURG
State: MD
PostalCode: 21784
CountryCode: US
TelephoneNumber: 4106441880
FaxNumber: 4106446048
Other Information
ProviderEnumerationDate: 05/19/2011
LastUpdateDate: 02/21/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STARSONECK
AuthorizedOfficialFirstName: KATHY
AuthorizedOfficialMiddleName: A.
AuthorizedOfficialTitleorPosition: ADMINISTRATIVE ASSISTANT
AuthorizedOfficialTelephone: 4106441880
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
335E00000X  N SuppliersProsthetic/Orthotic Supplier 
207XS0106X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
207XS0117X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
207XX0005X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
2081P2900X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
213ES0103X  N193200000X MULTI-SPECIALTY GROUPPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
207XS0114X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
207X00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


Home