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Contact Information

SYNERGY REVITALIZE MEDICAL CENTER, LLC
5457 TWIN KNOLLS RD STE 300-S6
COLUMBIA, MD21045-3259
 Phone: 301-602-4658
 Fax: 301-500-3114
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Brain Injury Medicine

2081P0301X 25 Physician/Physical Medicine and Rehabilitation
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SYNERGY REVITALIZE MEDICAL CENTER LLC · (Female)

NPI # 1558006957
Status Active
Credentials
Entity Individual
Enumeration date 04/29/2022
Last updated 05/15/2026 - About 3 weeks ago
Sole proprietor 1 Not specified
Identifiers
  • MD Medicaid 598055100
  • MA Other 1295045755 NPPES
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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