NPIMap

Organization Active NPI

Mid-Atlantic Addiction Medicine LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Millersville, MD
National Provider Identifier
1225583123
Registry record updated Aug 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MID-ATLANTIC ADDICTION MEDICINE LLC
Practice address
1110 Benfield Blvd
Suite H
Millersville, MD 21108-2639
Phone
(410) 800-4466
Fax
(410) 705-5024
NPI assigned
Aug 20, 2016
Last updated
Aug 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2016

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

Authorized official

Name
Dr. Ehsan Abdeshahian, MD
Title
Medical Director
Phone
(410) 800-4466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1110 Benfield Blvd
Suite H
Millersville, MD 21108-2639

Mailing address

1110 Benfield Blvd
Suite H
Millersville, MD 21108-2639
Phone (410) 800-4466

National Provider Directory

National Provider Directory
Tax ID family
Mid Atlantic Addiction Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471651200000",
    "number": "1225583123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 BENFIELD BLVD",
            "address_2": "SUITE H",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082639",
            "telephone_number": "410-800-4466",
            "fax_number": "410-705-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BENFIELD BLVD",
            "address_2": "SUITE H",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082639",
            "telephone_number": "410-800-4466",
            "fax_number": "410-705-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC ADDICTION MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-20",
        "last_updated": "2016-08-20",
        "status": "A",
        "authorized_official_last_name": "ABDESHAHIAN",
        "authorized_official_first_name": "EHSAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-800-4466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2016; 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.