Provider Demographics
NPI:1174576896
Name:PHYSICIAN MANAGEMENT, LTD.
Entity type:Organization
Organization Name:PHYSICIAN MANAGEMENT, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:FASTOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-652-2707
Mailing Address - Street 1:7900 WISCONSIN AVE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3601
Mailing Address - Country:US
Mailing Address - Phone:301-652-2707
Mailing Address - Fax:301-907-4570
Practice Address - Street 1:1505 W SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6912
Practice Address - Country:US
Practice Address - Phone:856-641-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital