Provider Demographics
NPI:1194763367
Name:PLASTIC & COSMETIC SURGEONS, P.A.
Entity type:Organization
Organization Name:PLASTIC & COSMETIC SURGEONS, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:ORLANDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-433-4300
Mailing Address - Street 1:5601 LOCH RAVEN BLVD
Mailing Address - Street 2:POB, SUITE 101
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2905
Mailing Address - Country:US
Mailing Address - Phone:410-433-4300
Mailing Address - Fax:410-433-4491
Practice Address - Street 1:5601 LOCH RAVEN BLVD
Practice Address - Street 2:POB, SUITE 101
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2905
Practice Address - Country:US
Practice Address - Phone:410-433-4300
Practice Address - Fax:410-433-4491
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLASTIC & COSMETIC SURGEONS, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1188261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408798400Medicaid
MD21-C0001188OtherRAILROAD MEDICARE ID
MD021VOtherBCBS PROVIDER NUMBER
MDCC8330OtherRAILROAD MEDICARE
MDCC8330OtherRAILROAD MEDICARE