Neurology Clinic Of Maryland, Inc. | |
10770 Hickory Ridge Rd Columbia MD 21044-3646 | |
(410) 988-4013 | |
Not Available |
Full Name | Neurology Clinic Of Maryland, Inc. |
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Speciality | Clinic/Center |
Location | 10770 Hickory Ridge Rd, Columbia, Maryland |
Authorized Official Name and Position | Sheetal Harish Wagle (SOLE OWNER) |
Authorized Official Contact | 4109884013 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neurology Clinic Of Maryland, Inc. 10770 Hickory Ridge Rd Columbia MD 21044-3646 Ph: (410) 988-4013 | Neurology Clinic Of Maryland, Inc. 10770 Hickory Ridge Rd Columbia MD 21044-3646 Ph: (410) 988-4013 |
NPI Number | 1700166360 |
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Provider Enumeration Date | 08/26/2011 |
Last Update Date | 08/26/2011 |
Medicare PECOS PAC ID | 2466619838 |
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Medicare Enrollment ID | O20120214000193 |
Identifier | Type | State | Issuer |
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1700166360 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | D0072106 (Maryland) | Primary |
Provider Name | Sheetal Wagle |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1508075276 PECOS PAC ID: 8527239649 Enrollment ID: I20110922000091 |
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