| Maryland Neurological Center, Llc | |
|
11085 Little Patuxent Pkwy Suite 212 Columbia MD 21044-2983 | |
| (410) 730-1212 | |
| (410) 730-2812 |
| Full Name | Maryland Neurological Center, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11085 Little Patuxent Pkwy, Columbia, Maryland |
| Authorized Official Name and Position | Michael Gearhart (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4107301212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Neurological Center, Llc 11085 Little Patuxent Pkwy Suite 212 Columbia MD 21044-2983 Ph: (410) 730-1212 | Maryland Neurological Center, Llc 11085 Little Patuxent Pkwy Suite 212 Columbia MD 21044-2983 Ph: (410) 730-1212 |
| NPI Number | 1205950656 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0941265664 |
|---|---|
| Medicare Enrollment ID | O20041122001081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205950656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Luke Ing Kao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639144330 PECOS PAC ID: 0648284430 Enrollment ID: I20100125000558 |
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