Basic Information
| Provider Information | |||||||||
| NPI: | 1992945471 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITALIST MEDICINE PHYSICIANS OF MARYLAND PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5410 MARYLAND WAY | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370275064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153775600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3001 HOSPITAL DR | ||||||||
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| City: | CHEVERLY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207851189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153775658 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2009 | ||||||||
| LastUpdateDate: | 01/11/2012 | ||||||||
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| AuthorizedOfficialLastName: | HOUFF | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | L. | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6153775600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 418732600 | 05 | MD | MEDICAID |