| Erickson Health Medical Group Of Maryland, Pc | |
|
711 Maiden Choice Ln Catonsville MD 21228-3632 | |
| (410) 247-5602 | |
| (410) 242-1756 |
| Full Name | Erickson Health Medical Group Of Maryland, Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 711 Maiden Choice Ln, Catonsville, Maryland |
| Authorized Official Name and Position | Donna Ethel Rachuba (MEDICAL STAFF SERVICES DIRECTOR) |
| Authorized Official Contact | 4104022258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Erickson Health Medical Group Of Maryland, Pc Po Box 783712 Philadelphia PA 19178-3712 Ph: (800) 360-3851 | Erickson Health Medical Group Of Maryland, Pc 711 Maiden Choice Ln Catonsville MD 21228-3632 Ph: (410) 247-5602 |
| NPI Number | 1972114403 |
|---|---|
| Provider Enumeration Date | 08/10/2020 |
| Last Update Date | 08/10/2020 |
| Certification Date | 08/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972114403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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