Provider Demographics
NPI:1891980736
Name:MAUREEN CONROY D.O. & TOM HARTSUCH M.D.
Entity type:Organization
Organization Name:MAUREEN CONROY D.O. & TOM HARTSUCH M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:BRIDGET
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-777-0622
Mailing Address - Street 1:919 SETON DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1847
Mailing Address - Country:US
Mailing Address - Phone:301-777-0622
Mailing Address - Fax:301-777-0624
Practice Address - Street 1:919 SETON DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1847
Practice Address - Country:US
Practice Address - Phone:301-777-0622
Practice Address - Fax:301-777-0624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0055984207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCH4238OtherRAILROAD MEDICARE
MD407601000Medicaid
MD407601000Medicaid