Provider Demographics
NPI:1871058446
Name:MIDATLANTIC NEUROMONITORING LIMITED
Entity type:Organization
Organization Name:MIDATLANTIC NEUROMONITORING LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:C
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-370-0810
Mailing Address - Street 1:15312 SPENCERVILLE CT STE 201
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-6609
Mailing Address - Country:US
Mailing Address - Phone:301-370-0810
Mailing Address - Fax:240-342-2801
Practice Address - Street 1:125 HALF MILE RD STE 200
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-6749
Practice Address - Country:US
Practice Address - Phone:301-370-0810
Practice Address - Fax:240-342-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty