Provider Demographics
NPI:1225825086
Name:INTEGRATE DIAGNOSTICS
Entity type:Organization
Organization Name:INTEGRATE DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-547-8904
Mailing Address - Street 1:217 FELTON RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6419
Mailing Address - Country:US
Mailing Address - Phone:443-218-3379
Mailing Address - Fax:443-218-6973
Practice Address - Street 1:515 FAIRMOUNT AVE STE 100
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-8520
Practice Address - Country:US
Practice Address - Phone:443-218-3379
Practice Address - Fax:443-218-6738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Multi-Specialty