Provider Demographics
NPI:1285781229
Name:DAVID L. HIGGINS, M.D., P.C.
Entity type:Organization
Organization Name:DAVID L. HIGGINS, M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-232-1050
Mailing Address - Street 1:17904 GEORGIA AVENUE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-232-1050
Mailing Address - Fax:301-232-1044
Practice Address - Street 1:17904 GEORGIA AVENUE
Practice Address - Street 2:SUITE 215
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:301-232-1050
Practice Address - Fax:301-232-1044
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID L. HIGGINS, M.D., PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-04
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD42000207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD00A636D87Medicare ID - Type Unspecified
MD150644D87Medicare PIN
MD016028D87Medicare ID - Type Unspecified
MD00A637D87Medicare ID - Type Unspecified
MD221972ZBDVMedicare PIN
MD229072ZBDVMedicare PIN