| Magnatel Md Llc | |
|
6030 Daybreak Cir Ste A150-183 Clarksville MD 21029-1642 | |
| (844) 211-5235 | |
| Not Available |
| Full Name | Magnatel Md Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6030 Daybreak Cir Ste A150-183, Clarksville, Maryland |
| Authorized Official Name and Position | Eric Nixon (CEO) |
| Authorized Official Contact | 8442115235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnatel Md Llc 6030 Daybreak Cir Ste A150-183 Clarksville MD 21029-1642 Ph: (844) 211-5235 | Magnatel Md Llc 6030 Daybreak Cir Ste A150-183 Clarksville MD 21029-1642 Ph: (844) 211-5235 |
| NPI Number | 1619689817 |
|---|---|
| Provider Enumeration Date | 12/19/2022 |
| Last Update Date | 05/23/2024 |
| Medicare PECOS PAC ID | 7113391558 |
|---|---|
| Medicare Enrollment ID | O20230325000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619689817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Gordon Taylor |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699196204 PECOS PAC ID: 6800011925 Enrollment ID: I20140716000053 |
| Provider Name | Shelley L Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598803991 PECOS PAC ID: 7517116031 Enrollment ID: I20230325000047 |
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