| |
1017 E Baltimore St Baltimore MD 21202-4705 | |
(410) 467-6040 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Community Health |
Location | 1017 E Baltimore St, Baltimore, Maryland |
Authorized Official Name and Position | Patricia Cassatt (CEO) |
Authorized Official Contact | 4104676040 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2524 Kirk Ave Baltimore MD 21218-4826 Ph: (410) 467-6040 | 1017 E Baltimore St Baltimore MD 21202-4705 Ph: (410) 467-6040 |
NPI Number | 1073803888 |
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Provider Enumeration Date | 04/13/2011 |
Last Update Date | 12/12/2012 |
Identifier | Type | State | Issuer |
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1073803888 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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