| Physician Group Wpcc | |
|
630 W Fayette St Baltimore MD 21201-1543 | |
| (410) 209-6201 | |
| (410) 209-6209 |
| Full Name | Physician Group Wpcc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 630 W Fayette St, Baltimore, Maryland |
| Authorized Official Name and Position | Archie T. Wallace (CEO) |
| Authorized Official Contact | 4102096201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Group Wpcc 630 W Fayette St Baltimore MD 21201-1543 Ph: (410) 209-6201 | Physician Group Wpcc 630 W Fayette St Baltimore MD 21201-1543 Ph: (410) 209-6201 |
| NPI Number | 1568508927 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568508927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (Maryland) | Primary |
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