| Baltimore Medical System Inc | |
|
3120 Erdman Ave Baltimore MD 21213-1720 | |
| (410) 558-4800 | |
| (410) 675-8947 |
| Full Name | Baltimore Medical System Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3120 Erdman Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Shirley Sutton (PRESIDENT AND CEO) |
| Authorized Official Contact | 4105584891 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baltimore Medical System Inc 5525 Eastern Ave Ste 301 Baltimore MD 21224-2796 Ph: (410) 732-8800 | Baltimore Medical System Inc 3120 Erdman Ave Baltimore MD 21213-1720 Ph: (410) 558-4800 |
| NPI Number | 1902802705 |
|---|---|
| Provider Enumeration Date | 06/27/2005 |
| Last Update Date | 06/15/2023 |
| Medicare PECOS PAC ID | 5395653455 |
|---|---|
| Medicare Enrollment ID | O20040122000785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902802705 | NPI | - | NPPES |
| 376751500 | Medicaid | MD | |
| 376751502 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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