| |
2555 Harford Rd Baltimore MD 21218-4837 | |
(410) 396-6252 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Student Health |
Location | 2555 Harford Rd, Baltimore, Maryland |
Authorized Official Name and Position | Tyrone Alonzo Chapman (BILLING & REVENUE MGR.) |
Authorized Official Contact | 4437393253 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1001 E Fayette St Baltimore MD 21202-4715 Ph: (410) 396-4398 | 2555 Harford Rd Baltimore MD 21218-4837 Ph: (410) 396-6252 |
NPI Number | 1174739577 |
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Provider Enumeration Date | 05/15/2007 |
Last Update Date | 10/04/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174739577 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Secondary |
261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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