Provider Demographics
NPI:1336179175
Name:ARUNDEL HEART ASSOCIATES, PA
Entity type:Organization
Organization Name:ARUNDEL HEART ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-760-5100
Mailing Address - Street 1:7845 OAKWOOD RD
Mailing Address - Street 2:STE 106
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4280
Mailing Address - Country:US
Mailing Address - Phone:410-760-5100
Mailing Address - Fax:410-760-5932
Practice Address - Street 1:7845 OAKWOOD RD
Practice Address - Street 2:STE 106
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4280
Practice Address - Country:US
Practice Address - Phone:410-760-5100
Practice Address - Fax:410-760-5932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE17157Medicare UPIN
MDA72135Medicare UPIN
MDF71847Medicare UPIN
MDKK38Medicare PIN
MDB67107Medicare UPIN
MDF45959Medicare UPIN
MDH63121Medicare UPIN
MDB67159Medicare UPIN