| Erickson Health Medical Group Of Maryland Pc | |
|
711 Maiden Choice Ln Catonsville MD 21228-3632 | |
| (410) 247-5602 | |
| (410) 242-1756 |
| Full Name | Erickson Health Medical Group Of Maryland Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 711 Maiden Choice Ln, Catonsville, Maryland |
| Authorized Official Name and Position | Matthew J Narrett (VP AND CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 4104022257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Erickson Health Medical Group Of Maryland Pc 5730 Executive Dr Ste 230 Catonsville MD 21228-1762 Ph: (410) 247-5602 | Erickson Health Medical Group Of Maryland Pc 711 Maiden Choice Ln Catonsville MD 21228-3632 Ph: (410) 247-5602 |
| NPI Number | 1598816449 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 08/10/2023 |
| Medicare PECOS PAC ID | 2860304136 |
|---|---|
| Medicare Enrollment ID | O20080528000404 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598816449 | NPI | - | NPPES |
| T016 | Other | BCBS DC | |
| 008203100 | Medicaid | MD | |
| KG01SE | Other | BCBS MD |
| Provider Name | Bruce A Blumenthal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871562637 PECOS PAC ID: 0547158586 Enrollment ID: I20040310000273 |
| Provider Name | Dang H Vu |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1083674659 PECOS PAC ID: 3870499973 Enrollment ID: I20040421001636 |
| Provider Name | Abebe Sila Imiru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750310660 PECOS PAC ID: 4880684299 Enrollment ID: I20040517001162 |
| Provider Name | Ming Yi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295796704 PECOS PAC ID: 2860475910 Enrollment ID: I20040609001415 |
| Provider Name | Florence M Marcus |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1447386743 PECOS PAC ID: 9234109687 Enrollment ID: I20040731000048 |
| Provider Name | Stanley R Silverman |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1801814637 PECOS PAC ID: 0143297424 Enrollment ID: I20040915000885 |
| Provider Name | Etosha D Dixon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063473551 PECOS PAC ID: 9032173745 Enrollment ID: I20041112000786 |
| Provider Name | Ronald D. Jeffreys |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750347282 PECOS PAC ID: 4880659911 Enrollment ID: I20041130000763 |
| Provider Name | Terry M Tan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1285666818 PECOS PAC ID: 0547235970 Enrollment ID: I20051213000726 |
| Provider Name | Mariam H Bakir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346304060 PECOS PAC ID: 4688731649 Enrollment ID: I20090319000285 |
| Provider Name | Kathy Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104975622 PECOS PAC ID: 4082764337 Enrollment ID: I20090609000295 |
| Provider Name | Martin Linker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063570182 PECOS PAC ID: 3173555075 Enrollment ID: I20090618000284 |
| Provider Name | Matthew J Narrett |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1144293838 PECOS PAC ID: 3577475854 Enrollment ID: I20091111000688 |
| Provider Name | Pamela M Aung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871798223 PECOS PAC ID: 6406994342 Enrollment ID: I20091112000511 |
| Provider Name | Lisa Burke |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1548292204 PECOS PAC ID: 6103956842 Enrollment ID: I20100607000818 |
| Provider Name | Myla M Carpenter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073588596 PECOS PAC ID: 4486779824 Enrollment ID: I20100909000059 |
| Provider Name | Daina Buivys |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1881669687 PECOS PAC ID: 5991991200 Enrollment ID: I20101130000008 |
| Provider Name | Thomas F Morris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326056045 PECOS PAC ID: 6901861251 Enrollment ID: I20120710000216 |
| Provider Name | Lakshmi Meenakshisundaram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992968960 PECOS PAC ID: 8820164841 Enrollment ID: I20120920000111 |
| Provider Name | Assiatu B Barrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104100882 PECOS PAC ID: 8426210253 Enrollment ID: I20140611000691 |
| Provider Name | Nicole Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205283009 PECOS PAC ID: 8527352368 Enrollment ID: I20160802002278 |
| Provider Name | Anna R Lamdin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649635525 PECOS PAC ID: 8729376538 Enrollment ID: I20161011002349 |
| Provider Name | Mercy E Ijoma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255881686 PECOS PAC ID: 8426338385 Enrollment ID: I20161212000154 |
| Provider Name | Felicia Nicholsonbrown |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528128345 PECOS PAC ID: 4981707395 Enrollment ID: I20170613000027 |
| Provider Name | Erika F.a. Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669996773 PECOS PAC ID: 6901170661 Enrollment ID: I20170919001164 |
| Provider Name | Jubeth Fontanilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053808196 PECOS PAC ID: 4082979612 Enrollment ID: I20180531000184 |
| Provider Name | Shannon L Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922599984 PECOS PAC ID: 9931454659 Enrollment ID: I20180621001195 |
| Provider Name | Amy E Mutch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093907982 PECOS PAC ID: 2163590944 Enrollment ID: I20180814002581 |
| Provider Name | May Gerochi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699252585 PECOS PAC ID: 0648529222 Enrollment ID: I20180815000071 |
| Provider Name | Andrew Kundrat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366467607 PECOS PAC ID: 6002840063 Enrollment ID: I20190830001704 |
| Provider Name | Evelyn N Chukwurah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255908463 PECOS PAC ID: 0446640544 Enrollment ID: I20211203001891 |
| Provider Name | Renee A Pace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629423512 PECOS PAC ID: 5799030177 Enrollment ID: I20230208000716 |
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