| Bodyworks Medical | |
|
St. Agnes Medical Center 3455 Wilkens Ave Suite 100 Baltimore MD 21229 | |
| (240) 447-8036 | |
| Not Available |
| Full Name | Bodyworks Medical |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | St. Agnes Medical Center, Baltimore, Maryland |
| Authorized Official Name and Position | Phillip Sherman Ragland (PRESIDENT) |
| Authorized Official Contact | 2404483279 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bodyworks Medical 13013 Davenport Dr Brandywine MD 20613-5683 Ph: (202) 270-7542 | Bodyworks Medical St. Agnes Medical Center 3455 Wilkens Ave Suite 100 Baltimore MD 21229 Ph: (240) 447-8036 |
| NPI Number | 1265068373 |
|---|---|
| Provider Enumeration Date | 03/20/2020 |
| Last Update Date | 03/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265068373 | NPI | - | NPPES |
| 968419100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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