REGEN MEDICAL LLC


Address: 3916 Hickory Ave, Baltimore, MD 21211-1834
Phone: 4435525552

REGEN MEDICAL LLC (NPI# 1629615901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629615901
Entity Type Organization
Organization Name REGEN MEDICAL LLC
Practice Address 3916 Hickory Ave
Baltimore
MD 21211-1834
Practice Telephone 4435525552
Practice Fax Number 4106629884
Mailing Telephone 4435525552
Mailing Fax Number 4106629884
Enumeration Date 2019-12-05
Last Update Date 2019-12-05
Authorized Official Name MICHAEL A DORN JR. (OWNER)
Authorized Official Telephone 4435525552
Authorized Official Credential DC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Office Location

Street Address 3916 HICKORY AVE
City BALTIMORE
State MD
Zip Code 21211-1834

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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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Competitor

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City BALTIMORE
Zip Code 21211

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Dataset Information

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.

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