| Bayside Internal Medicine Llc | |
|
998 Hospitality Way, Suite 102 Bayside Internal Medicine, Llc Aberdeen MD 21001-1757 | |
| (410) 297-9500 | |
| (410) 297-9016 |
| Full Name | Bayside Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 998 Hospitality Way, Suite 102, Aberdeen, Maryland |
| Authorized Official Name and Position | Prashant Rehit Shukla (OWNER) |
| Authorized Official Contact | 4102979500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside Internal Medicine Llc 998 Hospitality Way, Suite 102 Bayside Internal Medicine, Llc Aberdeen MD 21001-1757 Ph: (410) 297-9500 | Bayside Internal Medicine Llc 998 Hospitality Way, Suite 102 Bayside Internal Medicine, Llc Aberdeen MD 21001-1757 Ph: (410) 297-9500 |
| NPI Number | 1326227216 |
|---|---|
| Provider Enumeration Date | 10/29/2007 |
| Last Update Date | 06/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326227216 | NPI | - | NPPES |
| KEB4BA | Other | MD | CAREFIRST |
| 489M | Other | MD | MEDICARE |
| NO GROUP # | Other | MD | MEDICAL ASSISTANCE OF MD |
| DG3049 | Other | GA | RAILROAD MEDICARE |
| G738 | Other | DC | CAREFIRST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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