| |
827 Linden Boulevard Baltimore MD 21202 | |
(410) 383-8300 | |
(410) 735-5243 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 827 Linden Boulevard, Baltimore, Maryland |
Authorized Official Name and Position | Dennis Cherot (PRESIDENT) |
Authorized Official Contact | 4107284090 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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827 Linden Ave Baltimore MD 21202-4606 Ph: (410) 383-8300 | 827 Linden Boulevard Baltimore MD 21202 Ph: (410) 383-8300 |
NPI Number | 1346540606 |
---|---|
Provider Enumeration Date | 11/02/2010 |
Last Update Date | 04/01/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346540606 | NPI | - | NPPES |
905611400 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Maryland) | Primary |
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