NPIMap

Organization Active NPI

Innovative MWLM LLC

  • General Practice Physician
  • Rosedale, MD
National Provider Identifier
1639979305
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
INNOVATIVE MWLM LLC
Practice address
9526 Philadelphia Rd
Rosedale, MD 21237-4106
Phone
(443) 512-8337
Fax
(443) 327-5282
NPI assigned
Mar 13, 2025
Last updated
Mar 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Authorized official

Name
Bryan MorrowNPI 1093760670
Title
Ceo
Phone
(443) 512-8337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

9526 Philadelphia Rd
Rosedale, MD 21237-4106

Mailing address

100 Walter Ward Blvd Ste 200
Abingdon, MD 21009-1285
Phone (443) 512-8337

National Provider Directory

National Provider Directory
Tax ID family
Innovative Healthcare Centers12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1639979305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WALTER WARD BLVD STE 200",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091285",
            "telephone_number": "443-512-8337",
            "fax_number": "443-327-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9526 PHILADELPHIA RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374106",
            "telephone_number": "443-512-8337",
            "fax_number": "443-327-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE MWLM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-512-8337"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.