Provider Demographics
NPI:1699714469
Name:MARYLAND HEALTHCARE ASSOCIATES LLC
Entity type:Organization
Organization Name:MARYLAND HEALTHCARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-705-7870
Mailing Address - Street 1:PO BOX 2130
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20604-2130
Mailing Address - Country:US
Mailing Address - Phone:301-705-7870
Mailing Address - Fax:301-705-9622
Practice Address - Street 1:12070 OLD LINE CTR
Practice Address - Street 2:SUITE 100
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2513
Practice Address - Country:US
Practice Address - Phone:301-705-7870
Practice Address - Fax:301-705-9622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKA29MAOtherCAREFIRST BCBS
DC2597OtherCAREFIRST BCBS
MD454LMedicare PIN
DC635492Medicare PIN
MDKA29MAOtherCAREFIRST BCBS