Baltimore Suburban Health, Llc | |
10085 Red Run Blvd Ste 306 Owings Mills MD 21117-4832 | |
(410) 653-0000 | |
(410) 653-5531 |
Full Name | Baltimore Suburban Health, Llc |
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Speciality | Internal Medicine |
Location | 10085 Red Run Blvd Ste 306, Owings Mills, Maryland |
Authorized Official Name and Position | Elliot S Rothschild (MANAGING MEMBER) |
Authorized Official Contact | 4106530000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Baltimore Suburban Health, Llc 10085 Red Run Blvd Ste 306 Owings Mills MD 21117-4832 Ph: (410) 653-0000 | Baltimore Suburban Health, Llc 10085 Red Run Blvd Ste 306 Owings Mills MD 21117-4832 Ph: (410) 653-0000 |
NPI Number | 1013955723 |
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Provider Enumeration Date | 06/03/2006 |
Last Update Date | 11/15/2024 |
Medicare PECOS PAC ID | 1850394677 |
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Medicare Enrollment ID | O20060817000251 |
Identifier | Type | State | Issuer |
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1013955723 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (Maryland) | Primary |
Provider Name | Elliot S Rothschild |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346203866 PECOS PAC ID: 5193728913 Enrollment ID: I20100312000698 |
Provider Name | Rachel S Benn |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558412239 PECOS PAC ID: 8820127392 Enrollment ID: I20100520000829 |
Provider Name | David R Roggen |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992713622 PECOS PAC ID: 5597950030 Enrollment ID: I20101110000925 |
Provider Name | Mark Girguis |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1477591154 PECOS PAC ID: 1850303165 Enrollment ID: I20150901000339 |
Provider Name | Yury Malachevsky |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326443086 PECOS PAC ID: 0749583391 Enrollment ID: I20160114002452 |
Provider Name | Nomy Thomas Jacob |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265046742 PECOS PAC ID: 5496161358 Enrollment ID: I20210302000252 |
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