Antoniades Spine L.L.C.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

D0047688 Issued in MD

Legal business name

ANTONIADES SPINE L.L.C.

Practice address

2014 S Tollgate Rd Ste 107
Bel Air, MD 21015-6010

Phone

(410) 466-8747

Fax

(443) 643-2088

NPI assigned

May 16, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Spiro Basil Antoniades, M.D.

Title

Sole Proprietor

Phone

(410) 446-8747

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1992962153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 626",
            "city": "GREAT RIVER",
            "state": "NY",
            "postal_code": "117390626",
            "telephone_number": "631-907-2186",
            "fax_number": "631-201-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 S TOLLGATE RD STE 107",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210156010",
            "telephone_number": "410-466-8747",
            "fax_number": "443-643-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTONIADES SPINE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "ANTONIADES",
        "authorized_official_first_name": "SPIRO",
        "authorized_official_middle_name": "BASIL",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "410-446-8747",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MD",
            "license": "D0047688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery of the Spine Physician in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Orthopaedic Surgery of the Spine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.