Waverly Internal Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WAVERLY INTERNAL MEDICINE, LLC

Practice address

11165 Stratfield CT
First Floor
Marriottsville, MD 21104-1650

Phone

(410) 442-8065

Fax

(410) 442-8067

NPI assigned

Mar 13, 2009

Last updated

Jun 7, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ndidi Bonique Feinberg, M.D.

Title

Physician/Owner

Phone

(240) 601-6434

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275868800000",
    "number": "1194966648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11165 STRATFIELD CT",
            "address_2": "1ST FLOOR",
            "city": "MARRIOTTSVILLE",
            "state": "MD",
            "postal_code": "211041625",
            "telephone_number": "410-442-8065",
            "fax_number": "410-442-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11165 STRATFIELD CT",
            "address_2": "FIRST FLOOR",
            "city": "MARRIOTTSVILLE",
            "state": "MD",
            "postal_code": "211041650",
            "telephone_number": "410-442-8065",
            "fax_number": "410-442-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2010-06-07",
        "status": "A",
        "authorized_official_last_name": "FEINBERG",
        "authorized_official_first_name": "NDIDI",
        "authorized_official_middle_name": "BONIQUE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "240-601-6434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Marriottsville, MD
• Providers in Marriottsville, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; 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.