| |
6730 Holabird Ave Baltimore MD 21222 | |
(410) 288-6226 | |
(410) 288-9048 |
Full Name | |
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Speciality | Internal Medicine |
Location | 6730 Holabird Ave, Baltimore, Maryland |
Authorized Official Name and Position | Mohammad Rahnama (CEO-PRIMARY OWNER) |
Authorized Official Contact | 4102885220 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6730 Holabird Ave Baltimore MD 21222-1700 Ph: (410) 288-6226 | 6730 Holabird Ave Baltimore MD 21222 Ph: (410) 288-6226 |
NPI Number | 1912030073 |
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Provider Enumeration Date | 03/14/2007 |
Last Update Date | 06/26/2018 |
Medicare PECOS PAC ID | 4385782366 |
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Medicare Enrollment ID | O20091111000606 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912030073 | NPI | - | NPPES |
E268 | Other | MD | FEDERAL BLUE SHIELD GRP# |
825231 | Other | MD | MAMSI-UNITED HEALTHCARE |
KA70AL | Other | MD | BLUE SHEILD OF MD GRP # |
124500700 | Medicaid | MD | |
CC2620 | Other | MD | MEDICARE RAILROAD GRP NUM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | D0044793 (Maryland) | Primary |
Provider Name | Lucinda L Mundorf |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1497732374 PECOS PAC ID: 7810913951 Enrollment ID: I20051018001242 |
Provider Name | Mary Hartman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184814923 PECOS PAC ID: 7416026182 Enrollment ID: I20080521000201 |
Provider Name | Deborah L Gallo |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477600161 PECOS PAC ID: 2264570282 Enrollment ID: I20091112000276 |
Provider Name | Mohammad R Rahnama |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1952458739 PECOS PAC ID: 3678611688 Enrollment ID: I20091118000018 |
Provider Name | Anastasios Tsiolakis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225430705 PECOS PAC ID: 3678795655 Enrollment ID: I20150113001174 |
Provider Name | Sonya L Miles |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023461043 PECOS PAC ID: 4385938323 Enrollment ID: I20170920001057 |
Provider Name | Timothy J Lederer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033695960 PECOS PAC ID: 2365781291 Enrollment ID: I20190311002079 |
Provider Name | Valdane Robinson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245631241 PECOS PAC ID: 5496187064 Enrollment ID: I20191120000698 |
Provider Name | Andrea Arroyo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548656655 PECOS PAC ID: 1850716499 Enrollment ID: I20200730000543 |
Provider Name | Caroline Drusano Chell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194571505 PECOS PAC ID: 4587197041 Enrollment ID: I20241023001608 |
Plume Health Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 E Pratt St, Baltimore, MD 21202 Phone: 720-248-4483 | |
Np Medical Solutions By Sheila Waller Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5119 Mcfaul Rd, Baltimore, MD 21206 Phone: 443-531-6248 | |
Health Care For The Homeless, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 421 Fallsway, Baltimore, MD 21202 Phone: 410-837-5533 Fax: 410-837-8020 |