| Gold Shield Medical Services Llc | |
|
1600 Crain Hwy S Ste 201 Glen Burnie MD 21061-6438 | |
| (410) 760-0098 | |
| Not Available |
| Full Name | Gold Shield Medical Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1600 Crain Hwy S Ste 201, Glen Burnie, Maryland |
| Authorized Official Name and Position | Kunmi Olalekan Majekodunmi (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4107600098 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gold Shield Medical Services Llc 1600 Crain Hwy S Ste 201 Glen Burnie MD 21061-6438 Ph: (410) 760-0098 | Gold Shield Medical Services Llc 1600 Crain Hwy S Ste 201 Glen Burnie MD 21061-6438 Ph: (410) 760-0098 |
| NPI Number | 1881201184 |
|---|---|
| Provider Enumeration Date | 09/30/2020 |
| Last Update Date | 10/06/2020 |
| Medicare PECOS PAC ID | 3173943925 |
|---|---|
| Medicare Enrollment ID | O20201015001783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881201184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Tahani L Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144492471 PECOS PAC ID: 5193882223 Enrollment ID: I20090317000443 |
| Provider Name | Kolapo Idowu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285020867 PECOS PAC ID: 3476800038 Enrollment ID: I20180727001786 |
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