Organization Active NPI

Brian P, Bach D.P.M.

  • Prosthetic/Orthotic Supplier
  • Clinton, MD
National Provider Identifier
1720266745
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
BRIAN P, BACH D.P.M.
Practice address
9015 Woodyard Rd
Suite 211
Clinton, MD 20735-4209
Phone
(301) 868-0087
NPI assigned
Jan 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Brian Phillip Bach, D.P.M.
Title
Physician
Phone
(301) 868-0087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

9015 Woodyard Rd
Suite 211
Clinton, MD 20735-4209

Mailing address

9015 Woodyard Rd
Suite 211
Clinton, MD 20735-4209
Phone (301) 868-0087

Other identifiers 1

IdentifierTypeStateIssuer
380598100MedicaidMD

National Provider Directory

National Provider Directory

Locations

9015 Woodyard Rd
Ste 211
Clinton, MD 20735
Phone (301) 868-0087

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1720266745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 WOODYARD RD",
            "address_2": "SUITE 211",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354209",
            "telephone_number": "301-868-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 WOODYARD RD",
            "address_2": "SUITE 211",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354209",
            "telephone_number": "301-868-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN P, BACH D.P.M.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "BACH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "301-868-0087",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380598100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.