Neuroservice Of Maryland PC
in Gaithersburg, MD. Organization (NPI-2).
NPI number1639604168
StatusActive
Last updated in NPPESApr 21, 2017
Details
- NPI
- 1639604168
- Entity type
- Organization (NPI-2)
- Legal business name
- Neuroservice Of Maryland PC
- Organization subpart
- No
- Enumeration date
- Apr 21, 2017
- Last updated
- Apr 21, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0600X | – | – | Yes | |
| 204R00000X | Electrodiagnostic Medicine | – | – | |
| 2084N0400X | Psychiatry & Neurology, Neurology | – | – | |
| 246ZE0600X | Specialist/Technologist, Other, Electroneurodiagnostic | – | – |
Practice location
325 Ellington BlvdPmb #454
Gaithersburg, MD 20878-4591
Phone 240-224-9504
Mailing address
325 Ellington BlvdPmb #454
Gaithersburg, MD 20878-4591
Authorized official
Thomas Raley
President
2402249504
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