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
-
Melissa Arzadon, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
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
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All providers in Berlin, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.