| Conduit Inc | |
|
3901 Park Heights Ave Baltimore MD 21215-7013 | |
| (443) 794-2253 | |
| Not Available |
| Full Name | Conduit Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3901 Park Heights Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Tangela Johnson (CEO) |
| Authorized Official Contact | 4437942253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conduit Inc 3901 Park Heights Ave Baltimore MD 21215-7013 Ph: (443) 794-2253 | Conduit Inc 3901 Park Heights Ave Baltimore MD 21215-7013 Ph: (443) 794-2253 |
| NPI Number | 1629663760 |
|---|---|
| Provider Enumeration Date | 03/01/2021 |
| Last Update Date | 10/27/2021 |
| Certification Date | 10/27/2021 |
| Medicare PECOS PAC ID | 4981073194 |
|---|---|
| Medicare Enrollment ID | O20221210000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629663760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Michael E Friedman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770967960 PECOS PAC ID: 2567457948 Enrollment ID: I20040415001087 |
| Provider Name | Temika L Heyward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730174574 PECOS PAC ID: 3476510819 Enrollment ID: I20050225000325 |
| Provider Name | Eyitayo Enitan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164726246 PECOS PAC ID: 8921303926 Enrollment ID: I20160301000718 |
| Provider Name | Jenene Mcdowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821552282 PECOS PAC ID: 9335596295 Enrollment ID: I20231114003066 |
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