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Contact Information

OPAL MEDICAL GROUP, P.A.
1126 OPAL COURT
HAGERSTOWN, MD21740
 Phone: 240-420-2666
 Fax: 240-420-0951
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for OPAL MEDICAL GROUP PA · (Female)

NPI # 1477639862
Status Active
Credentials
Entity Individual
Enumeration date 10/27/2006
Last updated 02/24/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • MD License # D52323
  • MD Medicaid 404343000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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