| Cognizant Protocol | |
|
6700 Alexander Bell Dr Ste 200 Columbia MD 21046 | |
| (443) 873-8992 | |
| Not Available |
| Full Name | Cognizant Protocol |
|---|---|
| Speciality | Social Worker |
| Location | 6700 Alexander Bell Dr Ste 200, Columbia, Maryland |
| Authorized Official Name and Position | Korlett Whitehead (CHIEF CLINICAL OFFICER) |
| Authorized Official Contact | 4436367978 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognizant Protocol 9757 Clocktower Ln Apt 303 Columbia MD 21046-3115 Ph: (443) 636-7978 | Cognizant Protocol 6700 Alexander Bell Dr Ste 200 Columbia MD 21046 Ph: (443) 873-8992 |
| NPI Number | 1437640729 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 12/20/2019 |
| Certification Date | 12/20/2019 |
| Medicare PECOS PAC ID | 3779913512 |
|---|---|
| Medicare Enrollment ID | O20200420001194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437640729 | NPI | - | NPPES |
| 927003500 | Medicaid | MD |
| Provider Name | Korlett Y Whitehead |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558867887 PECOS PAC ID: 6406286244 Enrollment ID: I20200420001371 |
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