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Contact Information

MID-ATLANTIC ENT, LLC
600 RIDGELY AVE STE 110
ANNAPOLIS, MD21401-1082
 Phone: 410-573-9191
 Fax: 410-573-5910
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Otolaryngology/Facial Plastic Surgery

207YX0905X 04 Physician/Otolaryngology
 

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for MID ATLANTIC ENT LLC · (Female)

NPI # 1770175978
Status Active
Credentials
Entity Individual
Enumeration date 02/09/2021
Last updated 10/10/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • MD Medicaid 502528100
  • Other FN66-0000 CAREFIRST BCBS
  • MD Other 9001272 AETNA
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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