Arzadon Family Practice PA

Organization Active NPI Family Medicine Physician · Berlin, MD

NPI 1447598602 · NPPES record last updated Jan 23, 2013

Key facts

NPI
1447598602
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
D0059847 (MD)
Legal business name
ARZADON FAMILY PRACTICE PA
Practice address
11042 Nicholas LN
Unit B102
Berlin, MD 21811-3299
Phone
(443) 523-0601
Fax
(410) 973-1453
NPI assigned
Jan 23, 2013
Organization subpart
No

Authorized official

Name
Melissa D Arzadon, M.D.
Title
Sole Proprietor/Provider
Phone
(443) 523-0601

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130314000041 MD Part B Supplier - Clinic/Group Practice 4587809884 Receives reassigned benefits from 2 practitioners
Practice locations: Berlin, MD

National Provider Directory

Locations

11042 Nicholas Ln
Berlin, MD 21811
Phone (443) 523-0601

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X D0059847 MD Yes

Addresses

Primary practice location

11042 Nicholas LN
Unit B102
Berlin, MD 21811-3299

Mailing address

PO Box 1340
Berlin, MD 21811-5340
Phone (443) 523-0601

Other names

  • Village Sq. Family Medicine Doing business as

Other providers in Berlin, MD

All providers in Berlin, MD · Family Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.