Provider Demographics
NPI:1871618934
Name:TOWSON GASTROENTEROLOGY ASSOCIATES,LLC
Entity type:Organization
Organization Name:TOWSON GASTROENTEROLOGY ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROUHANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-583-0300
Mailing Address - Street 1:6565 N CHARLES ST
Mailing Address - Street 2:SUITE 512
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6800
Mailing Address - Country:US
Mailing Address - Phone:410-583-0300
Mailing Address - Fax:410-583-0307
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:SUITE 512
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:410-583-0300
Practice Address - Fax:410-583-0307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1871618934Medicare NSC