| Primary Care Of Maryland Professional Corporation | |
|
4155 Glen Park Rd Nottingham MD 21236-1019 | |
| (410) 248-0661 | |
| Not Available |
| Full Name | Primary Care Of Maryland Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 4155 Glen Park Rd, Nottingham, Maryland |
| Authorized Official Name and Position | Greg V Tampus (OWNER) |
| Authorized Official Contact | 4439300161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Of Maryland Professional Corporation 216 Oak Valley Dr Bel Air MD 21014-5941 Ph: (410) 248-0661 | Primary Care Of Maryland Professional Corporation 4155 Glen Park Rd Nottingham MD 21236-1019 Ph: (410) 248-0661 |
| NPI Number | 1841066073 |
|---|---|
| Provider Enumeration Date | 11/29/2023 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Medicare PECOS PAC ID | 6305299074 |
|---|---|
| Medicare Enrollment ID | O20240130000081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841066073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Greg Victor Tampus |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1356679138 PECOS PAC ID: 2668507278 Enrollment ID: I20140125000233 |
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