| Bayside Family Practice,l.l.c. | |
|
538 Cynwood Dr Ste 2 Easton MD 21601-3887 | |
| (410) 763-8999 | |
| (410) 763-6949 |
| Full Name | Bayside Family Practice,l.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 538 Cynwood Dr Ste 2, Easton, Maryland |
| Authorized Official Name and Position | Jennifer Anne Hollywood (PHYSICIAN) |
| Authorized Official Contact | 4107638999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside Family Practice,l.l.c. 538 Cynwood Dr Ste 2 Easton MD 21601-3887 Ph: (410) 763-8999 | Bayside Family Practice,l.l.c. 538 Cynwood Dr Ste 2 Easton MD 21601-3887 Ph: (410) 763-8999 |
| NPI Number | 1700068160 |
|---|---|
| Provider Enumeration Date | 11/28/2007 |
| Last Update Date | 12/12/2007 |
| Medicare PECOS PAC ID | 5092903781 |
|---|---|
| Medicare Enrollment ID | O20101222000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700068160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0046820 (Maryland) | Primary |
| Provider Name | Jennifer Anne Hollywood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003868324 PECOS PAC ID: 6901094697 Enrollment ID: I20101222000277 |
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