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134 Owensville Rd West River MD 20778-9998 | |
(410) 867-1268 | |
(410) 867-8754 |
Full Name | |
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Speciality | Family Medicine |
Location | 134 Owensville Rd, West River, Maryland |
Authorized Official Name and Position | Christina Varga (REVENUE CYCLE MANAGER) |
Authorized Official Contact | 4108674700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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134 Owensville Road West River MD 20778-9998 Ph: (410) 867-1268 | 134 Owensville Rd West River MD 20778-9998 Ph: (410) 867-1268 |
NPI Number | 1225110067 |
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Provider Enumeration Date | 10/20/2006 |
Last Update Date | 03/17/2022 |
Medicare PECOS PAC ID | 0244229474 |
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Medicare Enrollment ID | O20040511001400 |
Identifier | Type | State | Issuer |
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1225110067 | NPI | - | NPPES |
404482700 | Medicaid | MD |