Plumtree Family Health Center, Llc | |
104 Plumtree Rd Ste 102 Bel Air MD 21015-6095 | |
(410) 569-4224 | |
(410) 569-4368 |
Full Name | Plumtree Family Health Center, Llc |
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Speciality | Family Medicine |
Location | 104 Plumtree Rd Ste 102, Bel Air, Maryland |
Authorized Official Name and Position | Roy Rothenberg (MEMBER, LLC) |
Authorized Official Contact | 4105694224 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Plumtree Family Health Center, Llc 104 Plumtree Rd Ste 102 Bel Air MD 21015-6095 Ph: (410) 569-4224 | Plumtree Family Health Center, Llc 104 Plumtree Rd Ste 102 Bel Air MD 21015-6095 Ph: (410) 569-4224 |
NPI Number | 1013106301 |
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Provider Enumeration Date | 10/23/2007 |
Last Update Date | 12/02/2011 |
Medicare PECOS PAC ID | 7113996653 |
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Medicare Enrollment ID | O20040930000712 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013106301 | NPI | - | NPPES |
CN5164 | Other | RAILROAD MEDICARE | |
751202300 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Robert Knight |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1639258932 PECOS PAC ID: 9032188578 Enrollment ID: I20091020000089 |
Provider Name | Kelsey Furstenberg |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558073155 PECOS PAC ID: 1355704149 Enrollment ID: I20230827000046 |
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