NPIMap

Organization Active NPI

Maryland Provo-I Medical Services, PC

  • Emergency Medicine Physician
  • Baltimore, MD
National Provider Identifier
1013002096
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MARYLAND PROVO-I MEDICAL SERVICES, PC
Practice address
900 Caton Ave
Baltimore, MD 21229-5201
Phone
(410) 368-2000
NPI assigned
Oct 4, 2006
Last updated
Feb 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Meyers, MDNPI 1134182439
Title
President
Phone
(214) 712-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

900 Caton Ave
Baltimore, MD 21229-5201

Mailing address

1717 Main Street
Suite 5200
Dallas, TX 75201
Phone (214) 712-2000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 125

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 125

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1013002096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAIN STREET",
            "address_2": "SUITE 5200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75201",
            "telephone_number": "214-712-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CATON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295201",
            "telephone_number": "410-368-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND PROVO-I MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "MEYERS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-712-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.