Provider Demographics
NPI:1871725366
Name:ADVANCED INPATIENT MEDICINE PC
Entity type:Organization
Organization Name:ADVANCED INPATIENT MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DELBRUGGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-949-0814
Mailing Address - Street 1:PO BOX 69233
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9233
Mailing Address - Country:US
Mailing Address - Phone:443-949-0814
Mailing Address - Fax:443-292-6814
Practice Address - Street 1:746 JEFFERSON AVE FL 4
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1624
Practice Address - Country:US
Practice Address - Phone:570-241-4715
Practice Address - Fax:570-319-9305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-17
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
164765Medicare PIN