Upper Crossroads Medical Group | |
2412 Baldwin Mill Rd Fallston MD 21047 | |
(410) 557-9191 | |
(410) 557-9191 |
Full Name | Upper Crossroads Medical Group |
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Speciality | General Practice |
Location | 2412 Baldwin Mill Rd, Fallston, Maryland |
Authorized Official Name and Position | Salvacion Garin Lazatin (PHYSICIAN/PARTNER) |
Authorized Official Contact | 4105579191 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Upper Crossroads Medical Group 2412 Baldwin Mill Rd Fallston MD 21047 Ph: (410) 557-9191 | Upper Crossroads Medical Group 2412 Baldwin Mill Rd Fallston MD 21047 Ph: (410) 557-9191 |
NPI Number | 1104290261 |
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Provider Enumeration Date | 11/30/2015 |
Last Update Date | 11/30/2015 |
Medicare PECOS PAC ID | 8224321401 |
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Medicare Enrollment ID | O20160726001284 |
Identifier | Type | State | Issuer |
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1104290261 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Salvacion G Lazatin |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1740329283 PECOS PAC ID: 5294028486 Enrollment ID: I20160726001516 |
Murli N Mathur, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1305 Fallston Rd, Fallston, MD 21047 Phone: 410-877-8494 Fax: 410-877-8494 | |
Albert S.c. Sun, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1716 Harford Rd, Suite 105, Fallston, MD 21047 Phone: 410-877-1733 Fax: 410-877-1733 |