| |
6701 N Charles St Baltimore MD 21204-6808 | |
(443) 849-3594 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 6701 N Charles St, Baltimore, Maryland |
Authorized Official Name and Position | Laurie Beyer (EXECUTIVE VICE PRES & CFO) |
Authorized Official Contact | 4438492519 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 631568 Baltimore MD 21263-1568 Ph: () - | 6701 N Charles St Baltimore MD 21204-6808 Ph: (443) 849-3594 |
NPI Number | 1902919210 |
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Provider Enumeration Date | 08/17/2006 |
Last Update Date | 06/05/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902919210 | NPI | - | NPPES |
956800000 | Medicaid | MD | |
S126 | Other | MD | CAREFIRST REGIONAL |
KJ74GB | Other | MD | CAREFIRST MARYLAND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Secondary |
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