Provider Demographics
NPI:1558100909
Name:MARYLAND ONCOLOGY HEMATOLOGY, P.A.
Entity type:Organization
Organization Name:MARYLAND ONCOLOGY HEMATOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-909-3301
Mailing Address - Street 1:11720 BELTSVILLE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3119
Mailing Address - Country:US
Mailing Address - Phone:240-223-1893
Mailing Address - Fax:301-326-2926
Practice Address - Street 1:6420 ROCKLEDGE DR STE 4200
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7847
Practice Address - Country:US
Practice Address - Phone:301-929-0765
Practice Address - Fax:301-929-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty