Infectious Disease Associates, P.a.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

D0057970 Issued in MD

Legal business name

INFECTIOUS DISEASE ASSOCIATES, P.A.

Practice address

2850 N Ridge Rd
Suite 203
Ellicott City, MD 21043-3464

Phone

(410) 418-8550

Fax

(410) 418-8552

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Mark Landrum, M.D.

Title

President

Phone

(410) 418-8550

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• B. MARK LANDRUM, M.D., P.A. Former legal business name

Locations

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298937600000",
    "number": "1154434116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2377",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210412377",
            "telephone_number": "410-418-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 N RIDGE RD",
            "address_2": "SUITE 203",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433464",
            "telephone_number": "410-418-8550",
            "fax_number": "410-418-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2011-03-01",
        "status": "A",
        "authorized_official_last_name": "LANDRUM",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-418-8550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MD",
            "license": "D0057970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE MARYLAND GRP #",
            "identifier": "G972",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST, MARYLAND GRP #",
            "identifier": "KES7IN",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "DA5812",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402077400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "B. MARK LANDRUM, M.D., P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Infectious Disease Physician in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Infectious Disease Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.