| |
5500 Knoll North Drive Suite 370 Columbia MD 21045-2393 | |
(410) 837-2050 | |
(410) 715-3734 |
Full Name | |
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Speciality | Clinic/Center |
Location | 5500 Knoll North Drive, Columbia, Maryland |
Authorized Official Name and Position | Kyle Easton (REVENUE CYCLE DIRECTOR) |
Authorized Official Contact | 4108372050 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1111 N Charles St Baltimore MD 21201-5505 Ph: (410) 837-2050 | 5500 Knoll North Drive Suite 370 Columbia MD 21045-2393 Ph: (410) 837-2050 |
NPI Number | 1821336959 |
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Provider Enumeration Date | 01/24/2013 |
Last Update Date | 03/31/2022 |
Medicare PECOS PAC ID | 5395644835 |
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Medicare Enrollment ID | O20131109000016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821336959 | NPI | - | NPPES |
132190100 | Medicaid | MD |
Ethos Health Maryland 3 Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10840 Little Patuxent Pkwy, Columbia, MD 21044 Phone: 352-732-5590 Fax: 352-732-0292 | |
Lorien Dialysis, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6334 Cedar Ln, Columbia, MD 21044 Phone: 410-750-7500 | |
Premier Medical Group Of Maryland Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10705 Charter Dr Ste 420, Columbia, MD 21044 Phone: 410-709-7432 | |
University Of Maryland Physicians, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5890 Waterloo Rd, Columbia, MD 21045 Phone: 410-667-2142 Fax: 410-799-9097 | |