| |
5411 Old Frederick Rd Suite 18 Baltimore MD 21229-2195 | |
(410) 788-4800 | |
(410) 788-6701 |
Full Name | |
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Speciality | Family Medicine |
Location | 5411 Old Frederick Rd, Baltimore, Maryland |
Authorized Official Name and Position | Damian Edwin Birchess (PARTNER) |
Authorized Official Contact | 4107884800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5411 Old Frederick Rd Suite 18 Baltimore MD 21229-2195 Ph: (410) 788-4800 | 5411 Old Frederick Rd Suite 18 Baltimore MD 21229-2195 Ph: (410) 788-4800 |
NPI Number | 1215090402 |
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Provider Enumeration Date | 12/18/2006 |
Last Update Date | 09/21/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215090402 | NPI | - | NPPES |
A731DE | Other | MD | BCBS |
R828 | Other | DC | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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