Braddock Medical Group P.A.

LBN: Braddock Medical Group P.A.
Braddock Medical Group P.A. is an health care organization with primary practice located at 912 Seton Dr , Cumberland MD 21502-1818. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Contractor, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty. Braddock Medical Group P.A. can be contacted via phone (301) 722-3111, or through Livengood, Paul Taylor via phone (301) 722-3111.

Contact Information

Primary practice address
912 Seton Dr Cumberland MD 21502-1818
Phone: (301) 722-3111
Fax: (301) 722-5135
Website:
Map and Directions
Authorized official contact:
Name: Livengood, Paul Taylor
Phone: (301) 722-3111

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1710980081
LBN Legal business name Braddock Medical Group P.A.
DBA Doing business as
Authorized official Livengood, Paul Taylor
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2005
Last updated Mar 21st, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710980081 NPPES
Pennsylvania MEDICAID 00874296
Pennsylvania MEDICAID 910291400
Pennsylvania Other 6216720003
Pennsylvania Other H529
Pennsylvania MEDICAID 0011509000

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