| Keon M Vasudevan, MD | |
|
7450 Albert Rd, 1st Floor, Brandywine, MD 20613-3035 | |
| (301) 888-2233 | |
| Not Available |
| Full Name | Keon M Vasudevan |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 7450 Albert Rd, Brandywine, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265793897 | NPI | - | NPPES |
| 550018400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | D79802 (Maryland) | Primary |
| Entity Name | Greater Baden Medical Service Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912927344 PECOS PAC ID: 4981632650 Enrollment ID: O20051017000645 |
| Mailing Address | Practice Location Address |
|---|---|
| Keon M Vasudevan, MD 7450 Albert Rd Fl 3, Brandywine, MD 20613-3035 Ph: (301) 888-2233 | Keon M Vasudevan, MD 7450 Albert Rd, 1st Floor, Brandywine, MD 20613-3035 Ph: (301) 888-2233 |
Margaret L Davis, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13605 Baden Westwood Road, Brandywine, MD 20613 Phone: 301-888-2233 Fax: 301-888-9133 | |
Dr. Rosemarie Walden Henry, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13605 Baden Westwood Road, Brandywine, MD 20613 Phone: 301-888-2233 Fax: 301-888-9133 | |
Saida Morenike Sanusi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 7450 Albert Rd, 1st, Brandywine, MD 20613 Phone: 301-888-2233 | |
Ana R Ibanez, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13605 Baden Westwood Road, Brandywine, MD 20613 Phone: 301-888-2233 |