Provider Demographics
NPI:1386804300
Name:HAGERSTOWN RHEUMATOLOGY ASSOCIATES, LLC
Entity type:Organization
Organization Name:HAGERSTOWN RHEUMATOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-663-6255
Mailing Address - Street 1:7115 GUILFORD DR STE 204
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-5236
Mailing Address - Country:US
Mailing Address - Phone:301-663-6255
Mailing Address - Fax:
Practice Address - Street 1:7115 GUILFORD DR STE 204
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-5236
Practice Address - Country:US
Practice Address - Phone:301-663-6255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0067471207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty