| |
4924 Campbell Blvd Suite 125 Baltimore MD 21236-5908 | |
(443) 461-1997 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 4924 Campbell Blvd, Baltimore, Maryland |
Authorized Official Name and Position | George H. Morison (PRESIDENT) |
Authorized Official Contact | 8049685700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5000 Cox Rd Glen Allen VA 23060-9263 Ph: (804) 822-3555 | 4924 Campbell Blvd Suite 125 Baltimore MD 21236-5908 Ph: (443) 461-1997 |
NPI Number | 1952552267 |
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Provider Enumeration Date | 10/06/2008 |
Last Update Date | 03/05/2024 |
Medicare PECOS PAC ID | 4385538735 |
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Medicare Enrollment ID | O20100930005865 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952552267 | NPI | - | NPPES |
CH7434 | Other | MD | MEDICARE RAILROAD GROUP NUMBER |
CH7433 | Other | RR MEDICARE GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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