| Emerge Baltimore Inc. | |
|
1803 Pennsylvania Ave Baltimore MD 21217-3235 | |
| (443) 366-6335 | |
| (855) 539-9696 |
| Full Name | Emerge Baltimore Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1803 Pennsylvania Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Freddy Godfrey (ADMINISTRATOR) |
| Authorized Official Contact | 4434143704 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerge Baltimore Inc. 1803 Pennsylvania Ave Baltimore MD 21217-3235 Ph: (443) 366-6335 | Emerge Baltimore Inc. 1803 Pennsylvania Ave Baltimore MD 21217-3235 Ph: (443) 366-6335 |
| NPI Number | 1891262135 |
|---|---|
| Provider Enumeration Date | 10/24/2018 |
| Last Update Date | 05/19/2020 |
| Medicare PECOS PAC ID | 2860812955 |
|---|---|
| Medicare Enrollment ID | O20201012000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891262135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | William B Lawson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750499406 PECOS PAC ID: 6800057928 Enrollment ID: I20201012000179 |
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