| White Marsh Psychiatric Associates, Llc | |
|
5024 Campbell Blvd Suite H Baltimore MD 21236-5974 | |
| (410) 931-6694 | |
| Not Available |
| Full Name | White Marsh Psychiatric Associates, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5024 Campbell Blvd, Baltimore, Maryland |
| Authorized Official Name and Position | Dianne C Denton (PRACTICE MANAGER) |
| Authorized Official Contact | 4109319280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Marsh Psychiatric Associates, Llc 5024 Campbell Blvd Suite H Baltimore MD 21236-5974 Ph: (410) 931-6694 | White Marsh Psychiatric Associates, Llc 5024 Campbell Blvd Suite H Baltimore MD 21236-5974 Ph: (410) 931-6694 |
| NPI Number | 1043466147 |
|---|---|
| Provider Enumeration Date | 08/08/2008 |
| Last Update Date | 09/18/2008 |
| Medicare PECOS PAC ID | 3072681105 |
|---|---|
| Medicare Enrollment ID | O20081002000513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043466147 | NPI | - | NPPES |
| 187200500 | Medicaid | MD | |
| 15410050 | Medicaid | MD |
| Provider Name | Efim Weinman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083676506 PECOS PAC ID: 8022186196 Enrollment ID: I20081003000140 |
| Provider Name | Robin I Lerner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215998703 PECOS PAC ID: 2769550748 Enrollment ID: I20081003000324 |
| Provider Name | Candis D Grace-lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023070414 PECOS PAC ID: 2961570098 Enrollment ID: I20081022000164 |
| Provider Name | Joseph R Kachik |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285773812 PECOS PAC ID: 2961570957 Enrollment ID: I20090102000166 |
| Provider Name | Larry E Fultz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164693172 PECOS PAC ID: 1759410921 Enrollment ID: I20100526000589 |
| Provider Name | Hugh G Ward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740242700 PECOS PAC ID: 5890975379 Enrollment ID: I20110216000300 |
| Provider Name | Corneliu Sanda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508155755 PECOS PAC ID: 9032371133 Enrollment ID: I20130716000041 |
| Provider Name | Travis C Frank |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558675470 PECOS PAC ID: 7315184744 Enrollment ID: I20150212001729 |
| Provider Name | Quinton G Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528411725 PECOS PAC ID: 4385922699 Enrollment ID: I20161020001284 |
| Provider Name | Osereme Nora Agboifo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750989042 PECOS PAC ID: 4183032881 Enrollment ID: I20210419001216 |
| Provider Name | Rebecca L Noll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720752173 PECOS PAC ID: 3274920251 Enrollment ID: I20220420003230 |
| Provider Name | Monica M Ngwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912646738 PECOS PAC ID: 2163899907 Enrollment ID: I20221107003219 |
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