NPIMap

Organization Active NPI

Innovative MWLM LLC

  • General Practice Physician
  • Aberdeen, MD
National Provider Identifier
1114775715
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
INNOVATIVE MWLM LLC
Practice address
136 S Philadelphia Blvd Ste C
Aberdeen, MD 21001-3203
Phone
(443) 512-8337
NPI assigned
May 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Bryan Morrow
Title
Ceo
Phone
(443) 512-8337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

136 S Philadelphia Blvd Ste C
Aberdeen, MD 21001-3203

Mailing address

9526 Philadelphia Rd
Rosedale, MD 21237-4106
Phone (443) 512-8337

Other names 1

  • Innovative Healthcare Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Innovative Healthcare Centers12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

136 S Philadelphia Blvd
Ste C
Aberdeen, MD 21001

NPI Registry JSON

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1114775715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9526 PHILADELPHIA RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374106",
            "telephone_number": "443-512-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S PHILADELPHIA BLVD STE C",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210013203",
            "telephone_number": "443-512-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE MWLM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-512-8337"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Healthcare Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.