| |
9755 Patuxent Woods Dr Ste 100 Columbia MD 21046-2288 | |
(800) 762-6282 | |
(410) 630-5781 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 9755 Patuxent Woods Dr Ste 100, Columbia, Maryland |
Authorized Official Name and Position | Tammy Muir (COMPLIANCE OFFICER) |
Authorized Official Contact | 4109105959 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
9755 Patuxent Woods Dr Ste 100 Columbia MD 21046-2288 Ph: (800) 762-6282 | 9755 Patuxent Woods Dr Ste 100 Columbia MD 21046-2288 Ph: (800) 762-6282 |
NPI Number | 1225617897 |
---|---|
Provider Enumeration Date | 04/02/2021 |
Last Update Date | 12/08/2023 |
Medicare PECOS PAC ID | 7517366149 |
---|---|
Medicare Enrollment ID | O20210601001832 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225617897 | NPI | - | NPPES |
Provider Name | Lauren S Cano |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912395310 PECOS PAC ID: 8729305172 Enrollment ID: I20150323002024 |
Provider Name | Maria B Mainolfi - Palarata |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265694608 PECOS PAC ID: 5597912410 Enrollment ID: I20160607000953 |
Provider Name | Anil Ashok Bajnath |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730568684 PECOS PAC ID: 4385959691 Enrollment ID: I20180718001378 |
Provider Name | Maria Montenegro |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003320359 PECOS PAC ID: 8527329119 Enrollment ID: I20181120002315 |
Provider Name | Samantha Suller |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962975474 PECOS PAC ID: 3476892944 Enrollment ID: I20190227001789 |
Provider Name | Ina Grundmann |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093989097 PECOS PAC ID: 6406255058 Enrollment ID: I20210602000032 |
Provider Name | Ashley Beccaloni |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285227355 PECOS PAC ID: 7416350905 Enrollment ID: I20210721001727 |
Provider Name | Margaret Woodwell |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1982279113 PECOS PAC ID: 2961808811 Enrollment ID: I20210901002035 |
Provider Name | Carl Lord |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1063462349 PECOS PAC ID: 1759447311 Enrollment ID: I20211006000054 |
Provider Name | Jennifer Schmidt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700868320 PECOS PAC ID: 0749679561 Enrollment ID: I20211117002055 |
Provider Name | Thomas Prather |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1972102317 PECOS PAC ID: 5991195638 Enrollment ID: I20211211000019 |
Provider Name | Megan Copeland |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1275022493 PECOS PAC ID: 8527459437 Enrollment ID: I20220104001882 |
Provider Name | Amelia Jo Carnohan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306579255 PECOS PAC ID: 8224404033 Enrollment ID: I20221019002634 |
Provider Name | Garrett Peed |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699497057 PECOS PAC ID: 9032586219 Enrollment ID: I20221031002928 |
Provider Name | Carolyn Cerswell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437889623 PECOS PAC ID: 9032576582 Enrollment ID: I20240513000859 |
Provider Name | Imani V Bryan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982489639 PECOS PAC ID: 6709328180 Enrollment ID: I20240613000966 |
Provider Name | Paulina Andrea Dubov |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194429936 PECOS PAC ID: 4082059076 Enrollment ID: I20240621001542 |
Provider Name | Soraya Salehi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235830845 PECOS PAC ID: 7517316763 Enrollment ID: I20240626001507 |
Provider Name | Sadia Ali |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417395971 PECOS PAC ID: 6709019847 Enrollment ID: I20240830000644 |
Provider Name | Viridiana Fuentes Rosales |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407530942 PECOS PAC ID: 5395286991 Enrollment ID: I20240923004085 |
Provider Name | Michelle Kavall |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396500807 PECOS PAC ID: 9032656327 Enrollment ID: I20240926002175 |
Provider Name | Ilya Rabkin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760822324 PECOS PAC ID: 9335360288 Enrollment ID: I20241010004184 |
Provider Name | Shreya Patel |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033798012 PECOS PAC ID: 5496163164 Enrollment ID: I20241016002409 |
Provider Name | Annie Ressalam |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1922392752 PECOS PAC ID: 4284933169 Enrollment ID: I20241018000851 |
Ethos Health Maryland 3 Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10840 Little Patuxent Pkwy, Columbia, MD 21044 Phone: 352-732-5590 Fax: 352-732-0292 | |
Lorien Dialysis, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6334 Cedar Ln, Columbia, MD 21044 Phone: 410-750-7500 | |
Premier Medical Group Of Maryland Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10705 Charter Dr Ste 420, Columbia, MD 21044 Phone: 410-709-7432 | |
University Of Maryland Physicians, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5890 Waterloo Rd, Columbia, MD 21045 Phone: 410-667-2142 Fax: 410-799-9097 | |