MARYLAND ONCOLOGY HEMATOLOGY P.A. (NPI# 1396710703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396710703 |
| Entity Type | Organization |
| Organization Name | MARYLAND ONCOLOGY HEMATOLOGY P.A. |
| Practice Address |
10710 Charter Drive Suite G020 Columbia MD 21044-3257 |
| Practice Telephone | 4109642212 |
| Practice Fax Number | 4109640380 |
| Mailing Telephone | 4109642212 |
| Mailing Fax Number | 4109640380 |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2010-12-07 |
| Authorized Official Name | DR. NICHOLAS W KOUTRELAKOS (PRESIDENT) |
| Authorized Official Telephone | 4109642212 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 400899500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336693431 | Maryland Oncology Hematology P.a. | Non-Pharmacy Dispensing Site | 12210 Plum Orchard Dr, Suite 211, Silver Spring, MD 20904-7911 | 2016-08-08 |
| Street Address |
10710 CHARTER DRIVE SUITE G020 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21044-3257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235134370 | David Ogola Nyanjom | Internal Medicine | 10710 Charter Drive, Ste 310, Columbia, MD 21044-3260 | 2005-06-16 |
| 1073739215 | Nora G Molloy-daly | Obstetrics & Gynecology | 10710 Charter Drive, Ste 200, Columbia, MD 21044-2858 | 2007-04-17 |
| 1245387273 | Lauren Elaine Mayer | Advanced Practice Midwife | 10710 Charter Drive, Suite 200, Columbia, MD 21044-2912 | 2007-01-04 |
| 1073580361 | Denise Michelle Kirkner-vourlos | Obstetrics & Gynecology | 10710 Charter Drive, Suite 200, Columbia, MD 21044-2912 | 2006-03-05 |
| 1316913486 | Maryland Endocrine, P.a. | Internal Medicine | 10710 Charter Drive, Suite 410, Columbia, MD 21044 | 2006-02-27 |
| 1104891076 | Pulmonary Disease and Critical Care Associates, Pa | Internal Medicine | 10710 Charter Drive, Suite 310, Columbia, MD 21044-3260 | 2006-02-22 |
| 1922003060 | Fernando C De Leon | Internal Medicine | 10710 Charter Drive, Ste 310, Columbia, MD 21044-3260 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699331 | Brightview Columbia, LLC | Alzheimer Center (Dementia Center) | 6670 Martin Road, Columbia, MD 21044 | 2020-11-03 |
| 1689291544 | Diana Matthews | Physical Therapist | 6016 Jerrys Drive, Columbia, MD 21044 | 2020-06-26 |
| 1902380926 | Bagiwa Healthcare Services LLC | Nursing Care | 10630 Little Patuxent Park Way, Suite 314i, Colombia, MD 21044 | 2018-09-17 |
| 1295228245 | April Bloom Assisted Living, LLC | Assisted Living Facility | 5037 East Durham Rd, Columbia, MD 21044 | 2018-06-13 |
| 1437659562 | La Shawna A Obame | Counselor | 10451 Twin Rivers Rd Ste 100, Columbia, MD 21044 | 2018-02-15 |
| 1205335262 | Rashida Annette Winestock | Registered Nurse | 10440 Little Patuxent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1215436274 | Terri Lynn Buzby | Registered Nurse | 10440 Little Patuxuent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1134628191 | Sarah Elizabeth Stiltner | Registered Nurse | 10440 Little Patuxent Pkwy Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1326547381 | David Oliver Sloan Jr. | Registered Nurse | 10440 Little Patuxent Parkway Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1467950980 | Jill Sheppard Davenport | Nutritionist | 10801 Hickory Ridge Rd Suite 215, C/o Holistic Child Psychiatry, Columbia, MD 21044 | 2018-01-30 |
| Find all providers in zip 21044 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912988536 | Mary Audrey Ackerman | Internal Medicine | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2005-11-10 |
| 1356322812 | Robert E Smith Jr. | Internal Medicine | 166 Stoneridge Drive, Columbia, SC 29210 | 2005-11-10 |
| 1568886273 | Columbia Comprehensive Cancer Care Clinic | Internal Medicine | 500 N Keene St, Suite 202, Columbia, MO 65201-8104 | 2014-02-17 |
| 1952657462 | Jaffar Hilli | Internal Medicine | One Hospital Drive, Columbia, MO 65212-0001 | 2012-08-02 |
| 1851654818 | Andrew Mcmorris Iliff | Internal Medicine | 1705 E Broadway Ste 100, Columbia, MO 65201 | 2012-06-24 |
| 1902196165 | Varun Choudary Dhulipala | Internal Medicine | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2011-04-08 |
| 1891084513 | Andrew Scott Mener | Internal Medicine | 10710 Charter Dr, Columbia, MD 21044-3128 | 2011-04-04 |
| 1730495250 | Liana Makarian | Internal Medicine | 1705 E Broadway, Columbia, MO 65201-7166 | 2010-08-21 |
| 1821271032 | Maryland Oncology Hematology, P.a. | Internal Medicine | 10710 Charter Dr, Suite G020, Columbia, MD 21044-3128 | 2007-12-11 |
| 1922205681 | Amruth Palla | Internal Medicine | 1 Hospital Dr, Columbia, MO 65212-0001 | 2007-06-27 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.