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5457 Twin Knolls Rd Ste 300-s11 Columbia MD 21045-3259 | |
(216) 357-8977 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 5457 Twin Knolls Rd Ste 300-s11, Columbia, Maryland |
Authorized Official Name and Position | Elaine M Taylor (CEO) |
Authorized Official Contact | 3016024658 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5457 Twin Knolls Rd Ste 300-s11 Columbia MD 21045-3259 Ph: (301) 602-4658 | 5457 Twin Knolls Rd Ste 300-s11 Columbia MD 21045-3259 Ph: (216) 357-8977 |
NPI Number | 1558006957 |
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Provider Enumeration Date | 04/29/2022 |
Last Update Date | 05/08/2024 |
Medicare PECOS PAC ID | 5193103349 |
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Medicare Enrollment ID | O20220601000393 |
Identifier | Type | State | Issuer |
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1558006957 | NPI | - | NPPES |
598055100 | Medicaid | MD | |
1295045755 | Other | MA | NPPES |
Provider Name | Elaine Taylor |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295045755 PECOS PAC ID: 8921372269 Enrollment ID: I20210209001606 |
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