| Opal Medical Group, P.a. | |
|
1126 Opal Court Hagerstown MD 21740 | |
| (240) 420-2666 | |
| (240) 420-0951 |
| Full Name | Opal Medical Group, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1126 Opal Court, Hagerstown, Maryland |
| Authorized Official Name and Position | Amy Renee Hose (OFFICE MANAGER) |
| Authorized Official Contact | 2404206909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Opal Medical Group, P.a. 1126 Opal Court Hagerstown MD 21740 Ph: (240) 420-2666 | Opal Medical Group, P.a. 1126 Opal Court Hagerstown MD 21740 Ph: (240) 420-2666 |
| NPI Number | 1477639862 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 02/24/2010 |
| Medicare PECOS PAC ID | 1658270301 |
|---|---|
| Medicare Enrollment ID | O20040102000138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477639862 | NPI | - | NPPES |
| 404343000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D52323 (Maryland) | Primary |
| Provider Name | Muhammad K Waseem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184665143 PECOS PAC ID: 8729987474 Enrollment ID: I20040102000165 |
| Provider Name | Farid Murshed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366483323 PECOS PAC ID: 7416856174 Enrollment ID: I20040102000179 |
| Provider Name | Valarie T Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578804274 PECOS PAC ID: 4183879539 Enrollment ID: I20130309000033 |
| Provider Name | Lucinda C Bender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134351984 PECOS PAC ID: 3476692526 Enrollment ID: I20170203000043 |
| Provider Name | Sophy K Kamau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265998355 PECOS PAC ID: 0749520153 Enrollment ID: I20190321002446 |
| Provider Name | Khadeja Q Baidoo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104467414 PECOS PAC ID: 1052745379 Enrollment ID: I20191219001726 |
| Provider Name | Yi Y Vance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306545736 PECOS PAC ID: 1850765256 Enrollment ID: I20230327001891 |
| Provider Name | Chhiar Ruma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215634183 PECOS PAC ID: 5496120156 Enrollment ID: I20230411001251 |
| Provider Name | Rita Akowuah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073129714 PECOS PAC ID: 3375905839 Enrollment ID: I20230815002564 |
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