Organization Active NPI

Marnas LLC

  • Primary Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1164652160
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
D0062148 Issued in MD
Legal business name
MARNAS LLC
Practice address
300 Armory PL
Suite 3 I
Baltimore, MD 21201-4603
Phone
(410) 650-4100
NPI assigned
Jul 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Authorized official

Name
Gedion Atnafu, M.D.
Title
Medical Director
Phone
(410) 650-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X D0062148 MD Primary

Addresses

Primary practice location

300 Armory PL
Suite 3 I
Baltimore, MD 21201-4603

Mailing address

12701 Truths Promise CT
Bowie, MD 20720-5600
Phone (301) 464-3087

Other identifiers 1

IdentifierTypeStateIssuer
408456000MedicaidMD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1164652160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 TRUTHS PROMISE CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207205600",
            "telephone_number": "301-464-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ARMORY PL",
            "address_2": "SUITE 3 I",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014603",
            "telephone_number": "410-650-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARNAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "ATNAFU",
        "authorized_official_first_name": "GEDION",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-650-4100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "D0062148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408456000",
            "state": "MD"
        }
    ],
    "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 Jul 23, 2009; 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.