| Blackwater Medical Associates, Llc | |
|
408 Byrn St Cambridge MD 21613-1910 | |
| (410) 228-1068 | |
| Not Available |
| Full Name | Blackwater Medical Associates, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 408 Byrn St, Cambridge, Maryland |
| Authorized Official Name and Position | Mark M Malkus (PRESIDENT) |
| Authorized Official Contact | 4102281068 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackwater Medical Associates, Llc 408 Byrn St Cambridge MD 21613-1910 Ph: (410) 228-1068 | Blackwater Medical Associates, Llc 408 Byrn St Cambridge MD 21613-1910 Ph: (410) 228-1068 |
| NPI Number | 1508986092 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508986092 | NPI | - | NPPES |
| 7810000800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0050804 (Maryland) | Primary |
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