| Medical Maryland Star Choice Llc | |
|
5999 Harpers Farm Rd Ste W230 Columbia MD 21044-3025 | |
| (410) 383-2250 | |
| (410) 383-8378 |
| Full Name | Medical Maryland Star Choice Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5999 Harpers Farm Rd Ste W230, Columbia, Maryland |
| Authorized Official Name and Position | Kinan Knaish (CEO) |
| Authorized Official Contact | 4103832250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Maryland Star Choice Llc 5999 Harpers Farm Rd Ste W230 Columbia MD 21044-3025 Ph: (410) 383-2250 | Medical Maryland Star Choice Llc 5999 Harpers Farm Rd Ste W230 Columbia MD 21044-3025 Ph: (410) 383-2250 |
| NPI Number | 1770190647 |
|---|---|
| Provider Enumeration Date | 09/25/2020 |
| Last Update Date | 02/08/2023 |
| Medicare PECOS PAC ID | 1153731765 |
|---|---|
| Medicare Enrollment ID | O20201111000857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770190647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Fernando A Delgado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346304490 PECOS PAC ID: 8921085564 Enrollment ID: I20040701001135 |
| Provider Name | Khawaja A Farooq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447281308 PECOS PAC ID: 9436255262 Enrollment ID: I20070510000436 |
| Provider Name | Ali M Yahya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013934181 PECOS PAC ID: 8022141803 Enrollment ID: I20100730000183 |
| Provider Name | Arman Janloo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710169446 PECOS PAC ID: 4981759875 Enrollment ID: I20110815000211 |
| Provider Name | Shankar Awasthi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487901518 PECOS PAC ID: 0749424646 Enrollment ID: I20140806000785 |
| Provider Name | Eduardo D Abarca-rojas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538447628 PECOS PAC ID: 4587883863 Enrollment ID: I20140918001318 |
| Provider Name | Dawit M Wubie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396981361 PECOS PAC ID: 3476678277 Enrollment ID: I20150213000417 |
| Provider Name | Kinan Knaish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821352113 PECOS PAC ID: 9335452218 Enrollment ID: I20150721002409 |
| Provider Name | Blessing Gabriel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629504477 PECOS PAC ID: 8224395157 Enrollment ID: I20171206002803 |
| Provider Name | Janet Ngwafu Ndumu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710494554 PECOS PAC ID: 6103171566 Enrollment ID: I20180626002637 |
| Provider Name | Althea L Mcleod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154521573 PECOS PAC ID: 8022362029 Enrollment ID: I20181109001925 |
| Provider Name | Ann Aldrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437713542 PECOS PAC ID: 8921332131 Enrollment ID: I20190917000365 |
| Provider Name | Morenike E Agboola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811469414 PECOS PAC ID: 0244667343 Enrollment ID: I20200303000015 |
| Provider Name | Oseremen L Okojie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114400066 PECOS PAC ID: 9234569716 Enrollment ID: I20200423003566 |
| Provider Name | Edward J Luschinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205447448 PECOS PAC ID: 1850718529 Enrollment ID: I20200826000836 |
| Provider Name | Banchayehu Gizaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992345888 PECOS PAC ID: 9739587619 Enrollment ID: I20211006003145 |
| Provider Name | Ijeoma V Okonkwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023625381 PECOS PAC ID: 0446644777 Enrollment ID: I20220302000021 |
| Provider Name | Anita L Tyndall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649870627 PECOS PAC ID: 7214336510 Enrollment ID: I20220408002270 |
| Provider Name | Abdullah Riar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588602593 PECOS PAC ID: 9335247741 Enrollment ID: I20231017000046 |
| Provider Name | Jayanthi Samuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952771941 PECOS PAC ID: 9537462775 Enrollment ID: I20240405003745 |
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