Dr Manuel J Datiles Iv, MD | |
5963 Exchange Dr Ste 100, Eldersburg, MD 21784-9256 | |
(410) 549-0900 | |
(410) 549-6121 |
Full Name | Dr Manuel J Datiles Iv |
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Gender | Male |
Speciality | Pediatrics |
Location | 5963 Exchange Dr Ste 100, Eldersburg, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043577000 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | D0079527 (Maryland) | Primary |
Entity Name | The Nemours Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366594699 PECOS PAC ID: 9537072483 Enrollment ID: O20040422000840 |
Mailing Address | Practice Location Address |
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Dr Manuel J Datiles Iv, MD 5963 Exchange Dr Ste 100, Eldersburg, MD 21784-9256 Ph: (410) 549-0900 | Dr Manuel J Datiles Iv, MD 5963 Exchange Dr Ste 100, Eldersburg, MD 21784-9256 Ph: (410) 549-0900 |
Cathy H Reifman, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1645 Liberty Rd, Suite 205, Eldersburg, MD 21784 Phone: 410-795-7300 | |
Dr. Edward Lee Perl, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1645 Liberty Rd, Suite 205, Eldersburg, MD 21784 Phone: 410-795-7300 Fax: 410-795-5078 | |
Bruce I Feinerman, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1645 Liberty Rd Ste 205, Eldersburg, MD 21784 Phone: 410-795-7300 | |
Dr. Jennifer A Kottra, D.O Pediatrics Medicare: Medicare Enrolled Practice Location: 1010 Liberty Rd Ste 100, Eldersburg, MD 21784 Phone: 410-549-0900 | |
Dr. Thomas Hickey, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1010 Liberty Rd, Suite 100, Eldersburg, MD 21784 Phone: 410-549-0900 Fax: 410-549-6121 |