| Md Family Care Llc | |
|
502 Lewis St Havre De Grace MD 21078-3420 | |
| (847) 227-0293 | |
| Not Available |
| Full Name | Md Family Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 502 Lewis St, Havre De Grace, Maryland |
| Authorized Official Name and Position | Rehan A Khan (PRESIDENT) |
| Authorized Official Contact | 8472270293 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Md Family Care Llc 502 Lewis St Havre De Grace MD 21078-3420 Ph: (847) 227-0293 | Md Family Care Llc 502 Lewis St Havre De Grace MD 21078-3420 Ph: (847) 227-0293 |
| NPI Number | 1316315088 |
|---|---|
| Provider Enumeration Date | 09/11/2015 |
| Last Update Date | 09/11/2015 |
| Medicare PECOS PAC ID | 2769762954 |
|---|---|
| Medicare Enrollment ID | O20161205001873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316315088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rehan Ahmad Khan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1497796619 PECOS PAC ID: 6305898487 Enrollment ID: I20050216000969 |
| Provider Name | Shaunyetta Conyelle Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871152371 PECOS PAC ID: 9537580667 Enrollment ID: I20200528001087 |
| Provider Name | Mamadou Sadio Diallo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164005104 PECOS PAC ID: 5799123832 Enrollment ID: I20240409001001 |
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