| Dept. Of Health-deep Creek Middle Wellness Center | |
|
1000 S Marlyn Ave Baltimore MD 21221-5939 | |
| (410) 887-4130 | |
| (410) 666-8748 |
| Full Name | Dept. Of Health-deep Creek Middle Wellness Center |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 1000 S Marlyn Ave, Baltimore, Maryland |
| Authorized Official Name and Position | David C Taylor (PRIVACY OFFICER) |
| Authorized Official Contact | 4108872077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dept. Of Health-deep Creek Middle Wellness Center 6401 York Rd 3rd Floor Baltimore MD 21212-2152 Ph: (410) 887-2077 | Dept. Of Health-deep Creek Middle Wellness Center 1000 S Marlyn Ave Baltimore MD 21221-5939 Ph: (410) 887-4130 |
| NPI Number | 1134499213 |
|---|---|
| Provider Enumeration Date | 01/06/2012 |
| Last Update Date | 04/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134499213 | NPI | - | NPPES |
| 420941900 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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