| |
107 Beacon Rd Baltimore MD 21220-3504 | |
(410) 686-9019 | |
(410) 687-1975 |
Full Name | |
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Speciality | Family Medicine |
Location | 107 Beacon Rd, Baltimore, Maryland |
Authorized Official Name and Position | Jamie L. Steele-white (CREDENTIALING ASSOCIATE) |
Authorized Official Contact | 4109333073 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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107 Beacon Rd Baltimore MD 21220-3504 Ph: (410) 686-9019 | 107 Beacon Rd Baltimore MD 21220-3504 Ph: (410) 686-9019 |
NPI Number | 1093942955 |
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Provider Enumeration Date | 06/18/2009 |
Last Update Date | 06/18/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093942955 | NPI | - | NPPES |
KT80 | Other | MD | CAREFIRST OF MD |
CC3132 | Other | MD | RAILROAD MEDICARE |
W652 | Other | MD | CAREFIRST OF DC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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