Provider Demographics
NPI:1427739085
Name:SAILWINDS MEDICAL, LLC
Entity type:Organization
Organization Name:SAILWINDS MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MCMULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:443-972-4204
Mailing Address - Street 1:1000 GOODWILL AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2972
Mailing Address - Country:US
Mailing Address - Phone:443-972-4204
Mailing Address - Fax:833-471-6001
Practice Address - Street 1:1000 GOODWILL AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2972
Practice Address - Country:US
Practice Address - Phone:443-972-4204
Practice Address - Fax:833-471-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty