| Nw Breast Care Ctr,hospitalist,pa, Shs Plastics,surgical House Staff | |
|
5401 Old Court Rd Randallstown MD 21133-5103 | |
| (410) 521-2200 | |
| Not Available |
| Full Name | Nw Breast Care Ctr,hospitalist,pa, Shs Plastics,surgical House Staff |
|---|---|
| Speciality | Hospitalist |
| Location | 5401 Old Court Rd, Randallstown, Maryland |
| Authorized Official Name and Position | David Mccormick (CFO) |
| Authorized Official Contact | 4107014618 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nw Breast Care Ctr,hospitalist,pa, Shs Plastics,surgical House Staff 5401 Old Court Rd Attn: Credentialing Randallstown MD 21133-5103 Ph: (410) 601-5524 | Nw Breast Care Ctr,hospitalist,pa, Shs Plastics,surgical House Staff 5401 Old Court Rd Randallstown MD 21133-5103 Ph: (410) 521-2200 |
| NPI Number | 1508961988 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 10/20/2021 |
| Medicare PECOS PAC ID | 6204739352 |
|---|---|
| Medicare Enrollment ID | O20040128000328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508961988 | NPI | - | NPPES |
| CN6601 | Other | MD | R/R MEDICARE GROUP # |
| Provider Name | Warren J Smith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831165000 PECOS PAC ID: 4486567948 Enrollment ID: I20031111000064 |
| Provider Name | Ijaz A Khan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851348155 PECOS PAC ID: 9638064579 Enrollment ID: I20040218001040 |
| Provider Name | Mikel D Daniels |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1730185091 PECOS PAC ID: 8729976782 Enrollment ID: I20040310000433 |
| Provider Name | Ajay Soodan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336175884 PECOS PAC ID: 9537157128 Enrollment ID: I20040503001407 |
| Provider Name | Zalman M Kahn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1649200205 PECOS PAC ID: 8325039431 Enrollment ID: I20040519000160 |
| Provider Name | Paresh M Shah |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1740274414 PECOS PAC ID: 9638152051 Enrollment ID: I20040608000830 |
| Provider Name | Ravi K Aloor |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1588702351 PECOS PAC ID: 2860464112 Enrollment ID: I20040809000420 |
| Provider Name | Avverahalli M Harish |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295796316 PECOS PAC ID: 6406824986 Enrollment ID: I20040923000821 |
| Provider Name | Chaitanya K Ravi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376504027 PECOS PAC ID: 0749183895 Enrollment ID: I20041207000141 |
| Provider Name | Pallavi P Kumar |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1407899578 PECOS PAC ID: 4284685454 Enrollment ID: I20050204000196 |
| Provider Name | Naznin Esphani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306846852 PECOS PAC ID: 1355394404 Enrollment ID: I20050301000333 |
| Provider Name | Alan S Davis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306895461 PECOS PAC ID: 5597710301 Enrollment ID: I20050315000359 |
| Provider Name | Steven Schwartz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194714329 PECOS PAC ID: 7911982954 Enrollment ID: I20050323000072 |
| Provider Name | Barry S Walters |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972533586 PECOS PAC ID: 0941248447 Enrollment ID: I20050425000134 |
| Provider Name | Dimitrios V Mavrophilipos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861537797 PECOS PAC ID: 1153360680 Enrollment ID: I20050425001221 |
| Provider Name | Jonathan D. Dubin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356300222 PECOS PAC ID: 3476592288 Enrollment ID: I20050502000422 |
| Provider Name | Zacharias V Mavrophilipos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366587297 PECOS PAC ID: 9931138260 Enrollment ID: I20050808000488 |
| Provider Name | Tanveer Gaibi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023060019 PECOS PAC ID: 7416987607 Enrollment ID: I20050817000623 |
| Provider Name | Suman B Rao |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1912976325 PECOS PAC ID: 8022040708 Enrollment ID: I20050901000729 |
| Provider Name | Jose Sturgis Boston |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093776817 PECOS PAC ID: 9830119296 Enrollment ID: I20051130000254 |
| Provider Name | Amandeep Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154364149 PECOS PAC ID: 0042231094 Enrollment ID: I20051219000173 |
| Provider Name | Allan J Chircus |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1093708810 PECOS PAC ID: 6406870872 Enrollment ID: I20060124000914 |
| Provider Name | Ramaswamy I Rangarajan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841251576 PECOS PAC ID: 3173528197 Enrollment ID: I20060926000517 |
| Provider Name | Waseema A Dalvi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427117555 PECOS PAC ID: 4880695923 Enrollment ID: I20070116000546 |
| Provider Name | Rinku X Mukherjee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649386350 PECOS PAC ID: 0244332435 Enrollment ID: I20070219000204 |
| Provider Name | Mayer Gorbaty |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1710083241 PECOS PAC ID: 7517069370 Enrollment ID: I20070226000061 |
| Provider Name | Nilesh J Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710099262 PECOS PAC ID: 1052413440 Enrollment ID: I20070305000269 |
| Provider Name | Alexis Malpica Blount |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679684450 PECOS PAC ID: 9436252855 Enrollment ID: I20070305000681 |
| Provider Name | Sana Misalati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881748259 PECOS PAC ID: 5496852360 Enrollment ID: I20070530000118 |
| Provider Name | Haritha Pendli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275676934 PECOS PAC ID: 0042304941 Enrollment ID: I20070924000114 |
| Provider Name | Andrew M Barnstein |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316940794 PECOS PAC ID: 5496709685 Enrollment ID: I20070925000292 |
| Provider Name | Babak S Pirouz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609072578 PECOS PAC ID: 6103912118 Enrollment ID: I20071022000306 |
| Provider Name | Ronald F Sher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447211586 PECOS PAC ID: 5991879413 Enrollment ID: I20080801000149 |
| Provider Name | Mohammed M Abuzahra |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053366013 PECOS PAC ID: 4587727615 Enrollment ID: I20090115000118 |
| Provider Name | Justin R Price |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1891908786 PECOS PAC ID: 0749330561 Enrollment ID: I20090616000572 |
| Provider Name | Martin Linker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063570182 PECOS PAC ID: 3173555075 Enrollment ID: I20090618000284 |
| Provider Name | Ajay S Hooda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649414921 PECOS PAC ID: 6901959568 Enrollment ID: I20090729000371 |
| Provider Name | Monique L Goma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740380906 PECOS PAC ID: 1052313848 Enrollment ID: I20090908000587 |
| Provider Name | James Petit |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023277951 PECOS PAC ID: 4688720758 Enrollment ID: I20090915000785 |
| Provider Name | Kenolisa C Onwueme |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336283720 PECOS PAC ID: 1759421282 Enrollment ID: I20091215000063 |
| Provider Name | Ayoku Oketunji |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083697312 PECOS PAC ID: 7214078781 Enrollment ID: I20100106000058 |
| Provider Name | Hafeez A Syed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952403701 PECOS PAC ID: 4385785807 Enrollment ID: I20100106000467 |
| Provider Name | Syed S Hosain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548244759 PECOS PAC ID: 3971644477 Enrollment ID: I20100115000040 |
| Provider Name | Michele A Shermak |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1790716603 PECOS PAC ID: 7911035860 Enrollment ID: I20100513000403 |
| Provider Name | Ramesh Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083894604 PECOS PAC ID: 2365574837 Enrollment ID: I20100719000672 |
| Provider Name | Darpan Bansal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659567816 PECOS PAC ID: 7911075148 Enrollment ID: I20100802000260 |
| Provider Name | Chintu Sharma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710032099 PECOS PAC ID: 6901907617 Enrollment ID: I20100806000286 |
| Provider Name | Harshinder S Sidhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982881298 PECOS PAC ID: 4880718865 Enrollment ID: I20100827000065 |
| Provider Name | Christine Mativo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760697924 PECOS PAC ID: 3870619703 Enrollment ID: I20100928000896 |
| Provider Name | Anitha Nallu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1164530275 PECOS PAC ID: 7012019219 Enrollment ID: I20101102001229 |
| Provider Name | James E Harris |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538381017 PECOS PAC ID: 8527249135 Enrollment ID: I20110301000945 |
| Provider Name | Rebecca J. Aiken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548562861 PECOS PAC ID: 8022290162 Enrollment ID: I20110310000158 |
| Provider Name | Donna M Beagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184792517 PECOS PAC ID: 8921284803 Enrollment ID: I20110510000407 |
| Provider Name | Barbara Lee Klimuszka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326350141 PECOS PAC ID: 6204012941 Enrollment ID: I20110516000112 |
| Provider Name | Suzette M Johnson Futrell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1871730739 PECOS PAC ID: 0143407965 Enrollment ID: I20110603000501 |
| Provider Name | Viet H Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245406636 PECOS PAC ID: 5496933368 Enrollment ID: I20110623000279 |
| Provider Name | Mohamed Mwinyimvua Mohamed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891081444 PECOS PAC ID: 8022288125 Enrollment ID: I20110829000276 |
| Provider Name | Francisco Pizarro |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1457333841 PECOS PAC ID: 5496760019 Enrollment ID: I20110914000322 |
| Provider Name | Mark Richard Katlic |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1265492516 PECOS PAC ID: 5496858961 Enrollment ID: I20111011000298 |
| Provider Name | Aneta P Gramatikova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124255450 PECOS PAC ID: 4688847866 Enrollment ID: I20111103000530 |
| Provider Name | Aruna K Paspula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003969536 PECOS PAC ID: 9638158124 Enrollment ID: I20120702000063 |
| Provider Name | Anita U Anigbo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497985964 PECOS PAC ID: 9032372404 Enrollment ID: I20120712000152 |
| Provider Name | Noman A Siddiqui |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467600924 PECOS PAC ID: 7012173750 Enrollment ID: I20120724000571 |
| Provider Name | Mario D Teran |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518109537 PECOS PAC ID: 4385899889 Enrollment ID: I20130307000493 |
| Provider Name | Kristie R Davalli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770850828 PECOS PAC ID: 5496900847 Enrollment ID: I20130311000014 |
| Provider Name | Claudiu Austin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699905612 PECOS PAC ID: 5496801383 Enrollment ID: I20130311000067 |
| Provider Name | Laila R Lalani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265591564 PECOS PAC ID: 9931295250 Enrollment ID: I20130528000213 |
| Provider Name | Ahmed R Ibrahim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780647321 PECOS PAC ID: 8325057110 Enrollment ID: I20130626000132 |
| Provider Name | Jagdeep S Obhrai |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1790765246 PECOS PAC ID: 2769435528 Enrollment ID: I20131120001537 |
| Provider Name | Fikre W Degefu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649402876 PECOS PAC ID: 3072764356 Enrollment ID: I20131126001553 |
| Provider Name | Mocho Mensah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932340932 PECOS PAC ID: 1658422522 Enrollment ID: I20140305000214 |
| Provider Name | Manie Juneja |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609868975 PECOS PAC ID: 8921085093 Enrollment ID: I20140620000914 |
| Provider Name | Dennis Emuron |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053604785 PECOS PAC ID: 6800026758 Enrollment ID: I20140812000093 |
| Provider Name | Anteneh W Zenebe |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1992962179 PECOS PAC ID: 5193849594 Enrollment ID: I20140813001083 |
| Provider Name | Shane Svoboda |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083930275 PECOS PAC ID: 7618104696 Enrollment ID: I20140825000298 |
| Provider Name | Hafiz Ahmad Raza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407144678 PECOS PAC ID: 0941429567 Enrollment ID: I20140915000342 |
| Provider Name | Eniola Adejumo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104110675 PECOS PAC ID: 8628292729 Enrollment ID: I20140916000350 |
| Provider Name | Rohitash Mehta |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750592952 PECOS PAC ID: 7315127826 Enrollment ID: I20140925001592 |
| Provider Name | Kinjal N Sheth |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417105727 PECOS PAC ID: 4284854720 Enrollment ID: I20141003000785 |
| Provider Name | Usman Waheed |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619187408 PECOS PAC ID: 3072659184 Enrollment ID: I20141015000126 |
| Provider Name | Zerihun Bekele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376960625 PECOS PAC ID: 6103047055 Enrollment ID: I20141020000279 |
| Provider Name | Tewodros B Teferra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700170552 PECOS PAC ID: 2668693060 Enrollment ID: I20141029000516 |
| Provider Name | Aung Kyaw Min Lal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467686386 PECOS PAC ID: 1557512803 Enrollment ID: I20141030000512 |
| Provider Name | Radhika Pilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760749170 PECOS PAC ID: 8729200282 Enrollment ID: I20141118000474 |
| Provider Name | Bisrat G Haile |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1548676430 PECOS PAC ID: 0143543249 Enrollment ID: I20141222001254 |
| Provider Name | Qasim Raza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235247511 PECOS PAC ID: 3072648781 Enrollment ID: I20150327000752 |
| Provider Name | Susan Mani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356384531 PECOS PAC ID: 0446287478 Enrollment ID: I20150330001224 |
| Provider Name | Emily Susan Reardon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912292400 PECOS PAC ID: 0143547257 Enrollment ID: I20150331000684 |
| Provider Name | Ogechi Opara |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811264971 PECOS PAC ID: 4486973492 Enrollment ID: I20150424000791 |
| Provider Name | Max R Kates |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487910600 PECOS PAC ID: 2062660111 Enrollment ID: I20150804004844 |
| Provider Name | Howard Wang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447592282 PECOS PAC ID: 0840428579 Enrollment ID: I20150804005758 |
| Provider Name | Nikolai Anton Sopko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013283472 PECOS PAC ID: 1355599747 Enrollment ID: I20150812008018 |
| Provider Name | Gezzer Ortega |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477808343 PECOS PAC ID: 9830404029 Enrollment ID: I20150818003078 |
| Provider Name | Bing Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457685455 PECOS PAC ID: 3375790439 Enrollment ID: I20150929000339 |
| Provider Name | Ali Entezari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770847527 PECOS PAC ID: 3678886132 Enrollment ID: I20151110002307 |
| Provider Name | Srivasavi K Chaganti |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144375551 PECOS PAC ID: 8123194396 Enrollment ID: I20160114000468 |
| Provider Name | Susan E Wozniak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053759407 PECOS PAC ID: 2264662964 Enrollment ID: I20160620001398 |
| Provider Name | Arjun H Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326276619 PECOS PAC ID: 6608028741 Enrollment ID: I20160623000039 |
| Provider Name | Kenechukwu Olufemi Chudy-onwugaje |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861749780 PECOS PAC ID: 1355632233 Enrollment ID: I20160623001726 |
| Provider Name | Christopher David Boyd |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609166552 PECOS PAC ID: 4880993575 Enrollment ID: I20160706001264 |
| Provider Name | Ashebir T Chekol |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184028177 PECOS PAC ID: 9234425760 Enrollment ID: I20160909001716 |
| Provider Name | Wouhabe Bancheno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023421427 PECOS PAC ID: 3476869827 Enrollment ID: I20161007001232 |
| Provider Name | Tyler Rickards |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962807867 PECOS PAC ID: 3870881105 Enrollment ID: I20161019001187 |
| Provider Name | James Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558810309 PECOS PAC ID: 0648559070 Enrollment ID: I20161108000420 |
| Provider Name | Raul Sebastian Laines |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1144512682 PECOS PAC ID: 7113208646 Enrollment ID: I20161221001143 |
| Provider Name | Padma Venkatraman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003077785 PECOS PAC ID: 4880864545 Enrollment ID: I20161228001966 |
| Provider Name | Patience Agbonavbare |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952651309 PECOS PAC ID: 4981844834 Enrollment ID: I20170126002000 |
| Provider Name | Alex Blair |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871910323 PECOS PAC ID: 0648498162 Enrollment ID: I20170223000162 |
| Provider Name | Magali N Tshiamala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326275538 PECOS PAC ID: 8325290711 Enrollment ID: I20170404001343 |
| Provider Name | Augusta Akpabio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134679392 PECOS PAC ID: 3375829922 Enrollment ID: I20170413001201 |
| Provider Name | Jessy Dhillon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821400318 PECOS PAC ID: 9537385695 Enrollment ID: I20170718001196 |
| Provider Name | Ayesha Awais |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851642904 PECOS PAC ID: 1850662438 Enrollment ID: I20170731002263 |
| Provider Name | Monica Hardy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619404381 PECOS PAC ID: 9436420320 Enrollment ID: I20170811000298 |
| Provider Name | Zeyad Schwen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902225618 PECOS PAC ID: 6103044409 Enrollment ID: I20170811001766 |
| Provider Name | Melissa Devito |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184884199 PECOS PAC ID: 5799905675 Enrollment ID: I20170926000956 |
| Provider Name | Nadege T Fackche |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194110684 PECOS PAC ID: 4981970951 Enrollment ID: I20171018001559 |
| Provider Name | Emilienne Nguatem Nkemayim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093224149 PECOS PAC ID: 0648546200 Enrollment ID: I20171026000029 |
| Provider Name | Tomika Coleman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013272699 PECOS PAC ID: 8123349115 Enrollment ID: I20180308000277 |
| Provider Name | Bartlomiej Kachniarz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144616350 PECOS PAC ID: 6103138508 Enrollment ID: I20180322000176 |
| Provider Name | Wondwossen Bekele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205221223 PECOS PAC ID: 8325396005 Enrollment ID: I20180813002418 |
| Provider Name | Latoya Silverton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205221504 PECOS PAC ID: 3072802180 Enrollment ID: I20180815001487 |
| Provider Name | Zhan Li |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710365697 PECOS PAC ID: 1254638760 Enrollment ID: I20180921001769 |
| Provider Name | Luis Horacio Quiroga |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013205731 PECOS PAC ID: 7911143946 Enrollment ID: I20180924000108 |
| Provider Name | Francis Xavier Creighton |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1871859959 PECOS PAC ID: 1951555077 Enrollment ID: I20181002003675 |
| Provider Name | Whitley Williams |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1679968101 PECOS PAC ID: 0345593646 Enrollment ID: I20181105000065 |
| Provider Name | Olubode Olufajo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942652458 PECOS PAC ID: 2567716392 Enrollment ID: I20181114002901 |
| Provider Name | Franca Kraenzlin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962865014 PECOS PAC ID: 0840565602 Enrollment ID: I20181206001463 |
| Provider Name | Delores B Turner Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881000859 PECOS PAC ID: 1456695873 Enrollment ID: I20181211002947 |
| Provider Name | Nidal N Babaa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396150371 PECOS PAC ID: 6305102468 Enrollment ID: I20181221002067 |
| Provider Name | Xueying Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386907475 PECOS PAC ID: 2365758984 Enrollment ID: I20181231000070 |
| Provider Name | Deepa Galaiya |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1871936112 PECOS PAC ID: 9931332798 Enrollment ID: I20190214002224 |
| Provider Name | Samuel Black |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194188094 PECOS PAC ID: 9436444825 Enrollment ID: I20190607001089 |
| Provider Name | Danielle Tanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144887407 PECOS PAC ID: 4486987021 Enrollment ID: I20190613000353 |
| Provider Name | Russell Becker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487048237 PECOS PAC ID: 4183917578 Enrollment ID: I20190709000012 |
| Provider Name | Nicholas Calotta |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962891564 PECOS PAC ID: 1355619768 Enrollment ID: I20190711001894 |
| Provider Name | Hillary Jenny |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750816732 PECOS PAC ID: 6103175203 Enrollment ID: I20190718001518 |
| Provider Name | Camille N Upchurch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730186347 PECOS PAC ID: 1850468620 Enrollment ID: I20190730001720 |
| Provider Name | Chau P To |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124415088 PECOS PAC ID: 1052648540 Enrollment ID: I20190806003454 |
| Provider Name | Neda Amini |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689020174 PECOS PAC ID: 8820388622 Enrollment ID: I20190809002676 |
| Provider Name | Matthew J Mayuiers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033452644 PECOS PAC ID: 4385946672 Enrollment ID: I20190909003049 |
| Provider Name | Marie Pereira |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124480637 PECOS PAC ID: 3971898727 Enrollment ID: I20191031000376 |
| Provider Name | Moses Obura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518514371 PECOS PAC ID: 8224360565 Enrollment ID: I20191106000347 |
| Provider Name | Willie Liang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275989915 PECOS PAC ID: 6305137365 Enrollment ID: I20200219000059 |
| Provider Name | Bonnylin Covey Van Winkle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538515275 PECOS PAC ID: 4284924143 Enrollment ID: I20200327003205 |
| Provider Name | James L Liu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730549882 PECOS PAC ID: 7517214000 Enrollment ID: I20200514001704 |
| Provider Name | Ian A Powelson |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1053739185 PECOS PAC ID: 0446542724 Enrollment ID: I20200618000113 |
| Provider Name | Matthew Ryan Louis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871098467 PECOS PAC ID: 1557619954 Enrollment ID: I20200722001472 |
| Provider Name | Nathaniel Darway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689204604 PECOS PAC ID: 3476977497 Enrollment ID: I20200723002427 |
| Provider Name | Olubisi Akinseloyin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619309010 PECOS PAC ID: 3476827197 Enrollment ID: I20200807000947 |
| Provider Name | Gashaw Dadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003342346 PECOS PAC ID: 4789929472 Enrollment ID: I20200901001679 |
| Provider Name | John Anagnostakos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255794269 PECOS PAC ID: 6800164153 Enrollment ID: I20200916003246 |
| Provider Name | Felicia Monique Austin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669913851 PECOS PAC ID: 9133548001 Enrollment ID: I20200925000621 |
| Provider Name | Christella Ajong Mbeboh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417476409 PECOS PAC ID: 5890114391 Enrollment ID: I20201002000859 |
| Provider Name | John Luck |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619332475 PECOS PAC ID: 5496003824 Enrollment ID: I20201020000952 |
| Provider Name | Hammad Qureshy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689749368 PECOS PAC ID: 8123073780 Enrollment ID: I20210202001375 |
| Provider Name | Hamza Abdur Rahim Khan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275023749 PECOS PAC ID: 1658627229 Enrollment ID: I20210305000027 |
| Provider Name | Haley Zlomke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831682574 PECOS PAC ID: 9335492156 Enrollment ID: I20210326001150 |
| Provider Name | Vincent Leonard Van Acht |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184919110 PECOS PAC ID: 3173770641 Enrollment ID: I20210426000494 |
| Provider Name | Sara Alothman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376923284 PECOS PAC ID: 0042611535 Enrollment ID: I20210622000271 |
| Provider Name | Shannon N Radomski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376002154 PECOS PAC ID: 2769716935 Enrollment ID: I20210720000532 |
| Provider Name | Gladys Fajimolu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417445701 PECOS PAC ID: 0143555102 Enrollment ID: I20210908000175 |
| Provider Name | Sintayehu F Kenea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467806190 PECOS PAC ID: 5092046813 Enrollment ID: I20210915004035 |
| Provider Name | Melinda Jorge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568862399 PECOS PAC ID: 3173898772 Enrollment ID: I20210929000223 |
| Provider Name | Peter E Friedell |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356360531 PECOS PAC ID: 4284527359 Enrollment ID: I20211020000329 |
| Provider Name | Brandon Lee Green |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467912410 PECOS PAC ID: 2567851108 Enrollment ID: I20211119000876 |
| Provider Name | Amna Aijaz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922596840 PECOS PAC ID: 7416294210 Enrollment ID: I20211220002744 |
| Provider Name | Arthur L Brannon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285194621 PECOS PAC ID: 3870985559 Enrollment ID: I20220110002724 |
| Provider Name | Mirza Baig |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578586236 PECOS PAC ID: 3072595743 Enrollment ID: I20220217000702 |
| Provider Name | Nirmal Guragain |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144699984 PECOS PAC ID: 2567706765 Enrollment ID: I20220502002432 |
| Provider Name | Adefolaseyi L Aderotoye |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891146585 PECOS PAC ID: 7012200207 Enrollment ID: I20220603002315 |
| Provider Name | Michael Charles O'laughlin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003344110 PECOS PAC ID: 4587939913 Enrollment ID: I20220708001777 |
| Provider Name | Rana Alqusairi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306306469 PECOS PAC ID: 2961738307 Enrollment ID: I20220815001849 |
| Provider Name | Rabia Basir |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033775564 PECOS PAC ID: 6608250436 Enrollment ID: I20220829001722 |
| Provider Name | Yashika Mayur Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659934032 PECOS PAC ID: 2163759630 Enrollment ID: I20220907001710 |
| Provider Name | Sara Jean Chiochetti |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053818724 PECOS PAC ID: 2567718646 Enrollment ID: I20220920000313 |
| Provider Name | Nastassia Brown |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1447818307 PECOS PAC ID: 2365777505 Enrollment ID: I20221004001461 |
| Provider Name | Sarfaraz Hasni |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679541502 PECOS PAC ID: 6002889359 Enrollment ID: I20230111001645 |
| Provider Name | Midori Pavielle Starks White |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972189413 PECOS PAC ID: 3678976974 Enrollment ID: I20230531003496 |
| Provider Name | Jennifer Lynn Brown |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225532773 PECOS PAC ID: 3678820990 Enrollment ID: I20230728002632 |
| Provider Name | Darien Keeling |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639757727 PECOS PAC ID: 5193188225 Enrollment ID: I20230823000030 |
| Provider Name | Julia Purchla |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467081133 PECOS PAC ID: 1355705575 Enrollment ID: I20230906003479 |
| Provider Name | Jennifer L Haynie |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194013615 PECOS PAC ID: 4486875630 Enrollment ID: I20231009000165 |
| Provider Name | Denika Dantzler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568817690 PECOS PAC ID: 9436505104 Enrollment ID: I20231101001454 |
| Provider Name | Garyn Trae Metoyer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376162461 PECOS PAC ID: 3577986314 Enrollment ID: I20231128000863 |
| Provider Name | Kevin Schlidt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255950234 PECOS PAC ID: 5991128472 Enrollment ID: I20231205000817 |
| Provider Name | Venkateswer R Addanki |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851543409 PECOS PAC ID: 3971639485 Enrollment ID: I20240326002576 |
| Provider Name | Adetounse Ademiluyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669889614 PECOS PAC ID: 9335589951 Enrollment ID: I20240430003019 |
| Provider Name | Aireen K Kuan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487017976 PECOS PAC ID: 8628316239 Enrollment ID: I20240514002025 |
On-time Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9846 Liberty Rd, Randallstown, MD 21133 Phone: 410-754-4343 | |
Best Health Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5415 Old Court Rd, Suit # 101, Randallstown, MD 21133 Phone: 410-922-1608 Fax: 410-922-1612 | |
Northwest Chf Program Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-521-2200 | |
Medical Legacy Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5310 Old Court Rd, Suite 305, Randallstown, MD 21133 Phone: 410-655-7100 Fax: 410-655-7917 | |
Avverahalli Harish Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5310 Old Court Road Suite 303, Randallstown, MD 21133 Phone: 410-655-0312 Fax: 410-655-0497 | |
Liberty Chiropractic & Physical Therapy Center At Randallstown Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8507 Liberty Road, Suite L1, Randallstown, MD 21133 Phone: 443-272-6763 Fax: 443-272-7834 | |
Mukta Medical Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5415 Old Court Rd, Suite 101, Randallstown, MD 21133 Phone: 410-922-2650 Fax: 410-922-1612 |