| Crediblecare Services Llc | |
|
4507 Lyons Cir Apt T3 Owings Mills MD 21117-6979 | |
| (571) 277-0779 | |
| Not Available |
| Full Name | Crediblecare Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4507 Lyons Cir, Owings Mills, Maryland |
| Authorized Official Name and Position | Derick Sonjong (PRESIDENT) |
| Authorized Official Contact | 5712770779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crediblecare Services Llc 4507 Lyons Run Cir Apt T3 Owings Mills MD 21117-6979 Ph: (571) 277-0779 | Crediblecare Services Llc 4507 Lyons Cir Apt T3 Owings Mills MD 21117-6979 Ph: (571) 277-0779 |
| NPI Number | 1699503227 |
|---|---|
| Provider Enumeration Date | 07/24/2024 |
| Last Update Date | 07/24/2024 |
| Certification Date | 07/17/2024 |
| Medicare PECOS PAC ID | 9537606470 |
|---|---|
| Medicare Enrollment ID | O20240808003760 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699503227 | NPI | - | NPPES |
| Provider Name | Derick Sonjong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851047690 PECOS PAC ID: 5799130704 Enrollment ID: I20231011002916 |
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