DR. GEORGE MICHAEL PELLEGRINO M.D., NPI 1609835800 — CUMBERLAND (MD)

NPI 1609835800

14+ Years Experience Individual

DR. GEORGE MICHAEL PELLEGRINO M.D.

03/17/2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1609835800
NPI NUMBER

About DR. GEORGE MICHAEL PELLEGRINO

DR. GEORGE MICHAEL PELLEGRINO is a provider established in CUMBERLAND, MD. The NPI number of DR. GEORGE MICHAEL PELLEGRINO is 1609835800 and was assigned on 03/17/2006. The practitioners primary taxonomy code is: 207Q00000X with license number: D0040095 MD .

Mailing address

  • City: CUMBERLAND
  • State: MD
  • Postal code: 215022436
  • Phone: 3017240061
  • Address: 200 GLENN ST

Primary Practice Address

  • Region : CUMBERLAND, MD
  • NPI : 1609835800
  • Phone : 3017240061
  • Postalcode : 215022436
  • Address : 200 GLENN ST

Provider taxonomy - Family Medicine

  • Taxonomy code: 207Q00000X
  • License number: D0040095
  • License state: MD

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Contacts:

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  • DR. GEORGE MICHAEL PELLEGRINO M.D.
  • Address : 200 GLENN ST
  • Region : CUMBERLAND, MD
  • NPI : 1609835800
  • Phone : 3017240061
  • Postalcode : 215022436

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address200 GLENN ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCUMBERLAND
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMD
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code215022436
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3017240061
The telephone number associated with the location address of the provider being identified.
NPI1609835800
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207Q00000X
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Provider Enumeration Date03/17/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. GEORGE MICHAEL PELLEGRINO
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address200 GLENN ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameCUMBERLAND
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code215022436
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3017240061
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1207Q00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Provider License Number 1D0040095
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1MD
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorX
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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