Glenard Medical Services, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

D0057787 Issued in MD

Legal business name

GLENARD MEDICAL SERVICES, PA

Practice address

1916 Crain Hwy S
Suite #7
Glen Burnie, MD 21061-5563

Phone

(410) 590-3424

Fax

(410) 590-3425

NPI assigned

Nov 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Raphael N Dodoo, MDNPI 1508835497

Title

Owner

Phone

(410) 590-3424

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raphael Dodoo, M.D.

  • Internal Medicine Physician
  • Glen Burnie, MD
  • NPI 1508835497
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1326220575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 CRAIN HWY S",
            "address_2": "SUITE #7",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615563",
            "telephone_number": "410-590-3424",
            "fax_number": "410-590-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 CRAIN HWY S",
            "address_2": "SUITE #7",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615563",
            "telephone_number": "410-590-3424",
            "fax_number": "410-590-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENARD MEDICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "DODOO",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-590-3424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0057787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen Burnie MD Endoscopy ASC LLC
• Glen Burnie Oral Surgery Associates PC
• Glen Burnie Pharmacy
• Glen Burnie Physical Therapy & Sportscare, LLC
• Glen Burnie Physicians
• Glensan Wellness and Laser Pain Center
• Gloria Kidz Dental LLC
• Gold Shield Medical Services LLC
• Marjorie Lynne Gold
• Tyler Goldberg

• Specialist in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.