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2310 N Charles St Baltimore MD 21218-5127 | |
| (410) 844-4110 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2310 N Charles St, Baltimore, Maryland |
| Authorized Official Name and Position | Nag Nelluri (PRESIDENT) |
| Authorized Official Contact | 4439954113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2310 N Charles St Baltimore MD 21218-5127 Ph: (410) 844-4110 | 2310 N Charles St Baltimore MD 21218-5127 Ph: (410) 844-4110 |
| NPI Number | 1689042541 |
|---|---|
| Provider Enumeration Date | 09/09/2015 |
| Last Update Date | 04/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689042541 | NPI | - | NPPES |
| 1689042541 | Other | MD | NPI NUMBER # |
| 4239041-00 | Medicaid | MD | |
| 4233417-00 | Medicaid | MD | |
| 1053719575 | Other | MD | NPI NUMBER |
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