John Douglass Wallop in Annapolis - Sports
John Douglass Wallop - NPI 1275526253
John Douglass Wallop is a Sports in Annapolis, Maryland. John Douglass Wallop practices all healthcare services and medical treatments related to Sports. The NPI Number for John Douglass Wallop is 1275526253. The last update date is 2012-05-09.
John Douglass Wallop's current location address is 2661 Riva Rd, Annapolis, Maryland. You can contact this provider via phone number 4102666626 and fax number 4102663026. The mailing address for John Douglass Wallop is 2661 Riva Rd, Annapolis, Maryland. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Douglass Wallop |
|---|---|
| Address | 2661 Riva Rd, Annapolis, Maryland |
| Phone Number | 4102666626 |
| Fax Number | 4102663026 |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1275526253 |
|---|---|
| Provider Enumeration Date | 2005-08-25 |
| Last Updated Date | 2012-05-09 |
Provider Mailing Address Detail
| Address | 2661 Riva Rd |
|---|---|
| City | Annapolis |
| State | Maryland (MD) |
| Post Code | 214017353 |
| Phone Number | 4102666626 |
| Fax Number | 4102663026 |
Provider's Primary Taxonomy Detail
| Speciality | Sports |
|---|---|
| Taxonomy | 2251S0007X |
| Licence No | 17006 |
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Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, patholog |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 227912 | MD | MAMSI PROVIDER NUMBER | |
| 7947168 | MD | AETNA NON-HMO NUMBER | |
| 2621453 | MD | AETNA HMO NUMBER | |
| 53056502 | MD | BC REGION RENDERING # | |
| KN59 | MD | BLUE CROSS LOCAL # | |
| W0290002 | MD | BC FEDERAL, BLUE CHOICE # |
Post Comment/ Review Below
What is the unique identifier code issued to John Douglass Wallop by the Centers for Medicare & Medicaid Services?
The John Douglass Wallop has been assigned the NPI (National Provider Identifier) 1275526253. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where John Douglass Wallop is physically located?
The John Douglass Wallop is physically situated at the following address: 2661 Riva Rd, Annapolis, MD, 214017353.
What is the John Douglass Wallop's specialty and taxonomy code?
The John Douglass Wallop's specialty is Sports, and the corresponding taxonomy code is 2251S0007X.
When was the John Douglass Wallop's 1275526253 issued?
The John Douglass Wallop's 1275526253 was issued on 2005-08-25.
When was the information related to John Douglass Wallop most recently updated or refreshed?
The details pertaining to the John Douglass Wallop, including its address, specialty, and other relevant information, were last updated or refreshed on 2012-05-09.