| Md Pacs 2 Pc | |
|
106 Bow St Elkton MD 21921-5544 | |
| (954) 584-1000 | |
| Not Available |
| Full Name | Md Pacs 2 Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 106 Bow St, Elkton, Maryland |
| Authorized Official Name and Position | David Istvan (PRESIDENT) |
| Authorized Official Contact | 8656931000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Md Pacs 2 Pc 265 Brookview Centre Way Ste 400 Knoxville TN 37919-4052 Ph: (865) 693-1000 | Md Pacs 2 Pc 106 Bow St Elkton MD 21921-5544 Ph: (954) 584-1000 |
| NPI Number | 1083190516 |
|---|---|
| Provider Enumeration Date | 07/18/2018 |
| Last Update Date | 05/30/2024 |
| Medicare PECOS PAC ID | 9032468350 |
|---|---|
| Medicare Enrollment ID | O20220331001238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083190516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
| Provider Name | Jennifer Christian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750671608 PECOS PAC ID: 3678717378 Enrollment ID: I20130919000352 |
| Provider Name | Laura Lanyon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891377495 PECOS PAC ID: 7517357049 Enrollment ID: I20211124000442 |
| Provider Name | Oluwadamilola Fowowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760838783 PECOS PAC ID: 5890077184 Enrollment ID: I20230118000102 |
| Provider Name | Carissa Marie Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821307646 PECOS PAC ID: 2264627132 Enrollment ID: I20230706000588 |
| Provider Name | Akosua Neferteti Obeng-aduasare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598311896 PECOS PAC ID: 7911238571 Enrollment ID: I20230725003995 |
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