| Davids Loft Center For Somatic And Behavioral Healthcare | |
|
2641 Maryland Ave Baltimore MD 21218-4518 | |
| (410) 800-4226 | |
| Not Available |
| Full Name | Davids Loft Center For Somatic And Behavioral Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 2641 Maryland Ave, Baltimore, Maryland |
| Authorized Official Name and Position | David H Thompson (CEO) |
| Authorized Official Contact | 4108004285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Davids Loft Center For Somatic And Behavioral Healthcare 2641 Maryland Ave Baltimore MD 21218-4518 Ph: (410) 800-4226 | Davids Loft Center For Somatic And Behavioral Healthcare 2641 Maryland Ave Baltimore MD 21218-4518 Ph: (410) 800-4226 |
| NPI Number | 1992372312 |
|---|---|
| Provider Enumeration Date | 06/04/2021 |
| Last Update Date | 06/04/2021 |
| Medicare PECOS PAC ID | 3870981160 |
|---|---|
| Medicare Enrollment ID | O20211019000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992372312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Danae Wheatley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942241567 PECOS PAC ID: 4082776794 Enrollment ID: I20081215000104 |
| Provider Name | Janay Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952622391 PECOS PAC ID: 3678703600 Enrollment ID: I20140313000217 |
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