Provider Demographics
NPI:1922114743
Name:ALLAWAY & PAROUSIS UROLOGY MD PA
Entity type:Organization
Organization Name:ALLAWAY & PAROUSIS UROLOGY MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-724-0132
Mailing Address - Street 1:12234 WILLIAMS ROAD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502
Mailing Address - Country:US
Mailing Address - Phone:301-724-0132
Mailing Address - Fax:301-759-5874
Practice Address - Street 1:12234 WILLIAMS ROAD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:301-724-0132
Practice Address - Fax:301-759-5874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD090911400Medicaid
MD0976300001Medicare NSC
MD408LMedicare ID - Type Unspecified
MD090911400Medicaid