Root To Summit, Llc | |
8 Market Pl Ste 300 Baltimore MD 21202-4113 | |
(757) 912-0075 | |
(562) 261-1065 |
Full Name | Root To Summit, Llc |
---|---|
Speciality | Clinic/Center |
Location | 8 Market Pl Ste 300, Baltimore, Maryland |
Authorized Official Name and Position | Wan Rou Yang (PSYCHIATRIST) |
Authorized Official Contact | 7579120075 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Root To Summit, Llc 8 Market Pl Ste 300 Baltimore MD 21202-4113 Ph: (757) 912-0075 | Root To Summit, Llc 8 Market Pl Ste 300 Baltimore MD 21202-4113 Ph: (757) 912-0075 |
NPI Number | 1275300568 |
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Provider Enumeration Date | 12/06/2023 |
Last Update Date | 09/18/2024 |
Certification Date | 09/18/2024 |
Medicare PECOS PAC ID | 8426590878 |
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Medicare Enrollment ID | O20240613000008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275300568 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Wan Rou Yang |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1578126488 PECOS PAC ID: 5496177081 Enrollment ID: I20240613000014 |
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