Keon M Vasudevan, MD | |
7450 Albert Rd, 1st Floor, Brandywine, MD 20613-3035 | |
(301) 888-2233 | |
Not Available |
Full Name | Keon M Vasudevan |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 7450 Albert Rd, Brandywine, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265793897 | NPI | - | NPPES |
550018400 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | D79802 (Maryland) | Primary |
Entity Name | Greater Baden Medical Service Incorporated |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912927344 PECOS PAC ID: 4981632650 Enrollment ID: O20051017000645 |
Mailing Address | Practice Location Address |
---|---|
Keon M Vasudevan, MD 7450 Albert Rd Fl 3, Brandywine, MD 20613-3035 Ph: (301) 888-2233 | Keon M Vasudevan, MD 7450 Albert Rd, 1st Floor, Brandywine, MD 20613-3035 Ph: (301) 888-2233 |
Margaret L Davis, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13605 Baden Westwood Road, Brandywine, MD 20613 Phone: 301-888-2233 Fax: 301-888-9133 | |
Dr. Rosemarie Walden Henry, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13605 Baden Westwood Road, Brandywine, MD 20613 Phone: 301-888-2233 Fax: 301-888-9133 | |
Saida Morenike Sanusi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 7450 Albert Rd, 1st, Brandywine, MD 20613 Phone: 301-888-2233 | |
Ana R Ibanez, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13605 Baden Westwood Road, Brandywine, MD 20613 Phone: 301-888-2233 |