Dr. Tamader H. Mira, P.a. | |
5505 Ritchie Hwy E Brooklyn MD 21225-3444 | |
(410) 355-0340 | |
(410) 636-3403 |
Full Name | Dr. Tamader H. Mira, P.a. |
---|---|
Speciality | Internal Medicine |
Location | 5505 Ritchie Hwy, Brooklyn, Maryland |
Authorized Official Name and Position | Tamader Mira (PRESIDENT) |
Authorized Official Contact | 4104404827 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dr. Tamader H. Mira, P.a. 5505 Ritchie Hwy E Brooklyn MD 21225-3444 Ph: (410) 355-0340 | Dr. Tamader H. Mira, P.a. 5505 Ritchie Hwy E Brooklyn MD 21225-3444 Ph: (410) 355-0340 |
NPI Number | 1508830829 |
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Provider Enumeration Date | 02/14/2006 |
Last Update Date | 12/26/2021 |
Medicare PECOS PAC ID | 8729161484 |
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Medicare Enrollment ID | O20080219000261 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508830829 | NPI | - | NPPES |
912081500 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (Maryland) | Primary |
Provider Name | Tamader H Mira |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023205887 PECOS PAC ID: 4880777549 Enrollment ID: I20080327000302 |
Provider Name | Letitia J Wright |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992987499 PECOS PAC ID: 8022162056 Enrollment ID: I20090811000036 |
Provider Name | Daniella Villaran |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972231462 PECOS PAC ID: 8123486925 Enrollment ID: I20230627001913 |
Family Health Centers Of Baltimore, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3540 S Hanover St, Brooklyn, MD 21225 Phone: 410-355-0343 Fax: 410-355-5764 |