| |
22 S Greene St Baltimore MD 21201-1544 | |
(410) 328-8040 | |
(410) 328-0248 |
Full Name | |
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Speciality | Internal Medicine - Infectious Disease |
Location | 22 S Greene St, Baltimore, Maryland |
Authorized Official Name and Position | Lee Ann Buhrman (DIRECTOR OF PROFESSIONAL FEES) |
Authorized Official Contact | 4103288040 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 64442 Baltimore MD 21264-4442 Ph: (410) 328-8040 | 22 S Greene St Baltimore MD 21201-1544 Ph: (410) 328-8040 |
NPI Number | 1134179955 |
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Provider Enumeration Date | 05/11/2006 |
Last Update Date | 08/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134179955 | NPI | - | NPPES |
795021700 | Medicaid | MD | |
4005765 | Other | TN | BLUE CROSS/BLUE SHIELD |
041553700 | Medicaid | MD | |
034460903 | Medicaid | DC | |
1134179955 | Medicaid | DE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
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