Visavis Health Care Medical Group Of Md Llc | |
9200 Franklin Square Dr Baltimore MD 21237-4458 | |
(929) 491-7333 | |
Not Available |
Full Name | Visavis Health Care Medical Group Of Md Llc |
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Speciality | Family Medicine |
Location | 9200 Franklin Square Dr, Baltimore, Maryland |
Authorized Official Name and Position | Rekha Bhandari (OWNER) |
Authorized Official Contact | 2127346621 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Visavis Health Care Medical Group Of Md Llc 1481 Mcdonald Ave Fl 2 Brooklyn NY 11230-4667 Ph: () - | Visavis Health Care Medical Group Of Md Llc 9200 Franklin Square Dr Baltimore MD 21237-4458 Ph: (929) 491-7333 |
NPI Number | 1700649035 |
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Provider Enumeration Date | 01/31/2024 |
Last Update Date | 05/07/2024 |
Medicare PECOS PAC ID | 8022453638 |
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Medicare Enrollment ID | O20240305001068 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700649035 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Deanna Desire |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568180594 PECOS PAC ID: 6204203391 Enrollment ID: I20221102001595 |
Provider Name | Carissa Marie Kelly |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821307646 PECOS PAC ID: 2264627132 Enrollment ID: I20230706000588 |
Provider Name | Julia Didesiderio |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548717192 PECOS PAC ID: 9537441993 Enrollment ID: I20240307003931 |
Provider Name | Mariama Hubbard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518946763 PECOS PAC ID: 8628033156 Enrollment ID: I20240307004138 |
Provider Name | Irmalynn Mooneyham |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225470057 PECOS PAC ID: 4880838440 Enrollment ID: I20240313001771 |
Provider Name | Georgianne Allen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447736277 PECOS PAC ID: 5890026215 Enrollment ID: I20240318000343 |
Provider Name | Tiffany Young |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831842202 PECOS PAC ID: 0749666345 Enrollment ID: I20240321002330 |
Provider Name | Chassidy Leeann Sharp |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720475767 PECOS PAC ID: 8022322288 Enrollment ID: I20240424002992 |
Provider Name | Melissa Pagan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568081461 PECOS PAC ID: 1759766223 Enrollment ID: I20240506000481 |
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