Well-being Medical Care, Llc | |
5018 Dorsey Hall Dr Ste 104 Ellicott City MD 21042-7855 | |
(410) 730-8288 | |
Not Available |
Full Name | Well-being Medical Care, Llc |
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Speciality | Clinic/Center |
Location | 5018 Dorsey Hall Dr, Ellicott City, Maryland |
Authorized Official Name and Position | Kristin Marie Clark (PHYSICIAN AND OWNER) |
Authorized Official Contact | 4107308288 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Well-being Medical Care, Llc Po Box 640 Belleville NJ 07109-0640 Ph: (973) 751-7515 | Well-being Medical Care, Llc 5018 Dorsey Hall Dr Ste 104 Ellicott City MD 21042-7855 Ph: (410) 730-8288 |
NPI Number | 1467614032 |
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Provider Enumeration Date | 06/25/2008 |
Last Update Date | 03/04/2011 |
Medicare PECOS PAC ID | 3375673825 |
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Medicare Enrollment ID | O20100610000554 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467614032 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | D53966 (Maryland) | Primary |
Provider Name | Kristin M Clark |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932177508 PECOS PAC ID: 5294783247 Enrollment ID: I20050106000794 |
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