| Maryland Group Faculty Practice Llc | |
|
419 W Redwood St Suite 570 Baltimore MD 21201-1734 | |
| (410) 328-6106 | |
| (410) 328-1130 |
| Full Name | Maryland Group Faculty Practice Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 419 W Redwood St, Baltimore, Maryland |
| Authorized Official Name and Position | Michele James (OFFICE MANAGER) |
| Authorized Official Contact | 4105988700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Group Faculty Practice Llc 419 W Redwood St Suite 570 Baltimore MD 21201-1734 Ph: (410) 328-6106 | Maryland Group Faculty Practice Llc 419 W Redwood St Suite 570 Baltimore MD 21201-1734 Ph: (410) 328-6106 |
| NPI Number | 1104036300 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 10/14/2022 |
| Certification Date | 10/14/2022 |
| Medicare PECOS PAC ID | 5799671533 |
|---|---|
| Medicare Enrollment ID | O20040226001095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104036300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Maryland) | Primary |
| Provider Name | Barbara P Cohen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316043185 PECOS PAC ID: 1254384043 Enrollment ID: I20050221000574 |
| Provider Name | Yolanda M Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669676177 PECOS PAC ID: 8325131519 Enrollment ID: I20070904000532 |
| Provider Name | Rachael D Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619104742 PECOS PAC ID: 7113069634 Enrollment ID: I20100121000787 |
| Provider Name | Jewell E Benford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932257326 PECOS PAC ID: 1658548227 Enrollment ID: I20120123000332 |
| Provider Name | Wanda D Binns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083904478 PECOS PAC ID: 8123257391 Enrollment ID: I20140211000050 |
| Provider Name | Renee Bell Hoeckel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083044309 PECOS PAC ID: 9335439702 Enrollment ID: I20160526001714 |
| Provider Name | Carol Z Schulman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619094729 PECOS PAC ID: 9032147954 Enrollment ID: I20190325001832 |
| Provider Name | Nicholas S Kopp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720097132 PECOS PAC ID: 2961762604 Enrollment ID: I20210126000202 |
| Provider Name | Danielle E Herrmann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356771372 PECOS PAC ID: 3375958804 Enrollment ID: I20210216001448 |
| Provider Name | Barbara J Sadauski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922017979 PECOS PAC ID: 5991173064 Enrollment ID: I20221121001759 |
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