| Maryland Center For Neuro-ophthalmology & Neuro-otology, P.c. | |
|
11055 Little Patuxent Parkway Suite L2 Columbia MD 21044-2896 | |
| (410) 740-1000 | |
| (410) 740-1003 |
| Full Name | Maryland Center For Neuro-ophthalmology & Neuro-otology, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11055 Little Patuxent Parkway, Columbia, Maryland |
| Authorized Official Name and Position | Nathaniel Carter (PRESIDENT/CEO) |
| Authorized Official Contact | 4107401000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Center For Neuro-ophthalmology & Neuro-otology, P.c. 11055 Little Patuxent Parkway Suite L2 Columbia MD 21044-2896 Ph: (410) 740-1000 | Maryland Center For Neuro-ophthalmology & Neuro-otology, P.c. 11055 Little Patuxent Parkway Suite L2 Columbia MD 21044-2896 Ph: (410) 740-1000 |
| NPI Number | 1740455039 |
|---|---|
| Provider Enumeration Date | 04/28/2008 |
| Last Update Date | 05/19/2008 |
| Medicare PECOS PAC ID | 0749266948 |
|---|---|
| Medicare Enrollment ID | O20040628001313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740455039 | NPI | - | NPPES |
| 150602100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | D46633 (Maryland) | Primary |
| Provider Name | Nathaniel Carter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902863566 PECOS PAC ID: 1355330143 Enrollment ID: I20040507000548 |
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