| Endeavour Healthcare | |
|
913 Southerly Road 264 Towson MD 21204-2629 | |
| (443) 275-9164 | |
| (702) 977-7016 |
| Full Name | Endeavour Healthcare |
|---|---|
| Speciality | Internal Medicine |
| Location | 913 Southerly Road, Towson, Maryland |
| Authorized Official Name and Position | Dev Basu (SOLE MEMBER OWNER) |
| Authorized Official Contact | 4432759164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endeavour Healthcare 913 Southerly Road 264 Towson MD 21204-2629 Ph: (443) 275-9164 | Endeavour Healthcare 913 Southerly Road 264 Towson MD 21204-2629 Ph: (443) 275-9164 |
| NPI Number | 1104555127 |
|---|---|
| Provider Enumeration Date | 06/06/2022 |
| Last Update Date | 09/13/2024 |
| Medicare PECOS PAC ID | 3072988815 |
|---|---|
| Medicare Enrollment ID | O20230410002370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104555127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Dev A Basu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821386228 PECOS PAC ID: 9133363716 Enrollment ID: I20150917001875 |
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