| Chase Brexton Health Services, Inc. | |
|
1111 North Charles Street Baltimore MD 21201 | |
| (410) 837-2050 | |
| (410) 752-1374 |
| Full Name | Chase Brexton Health Services, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1111 North Charles Street, Baltimore, Maryland |
| Authorized Official Name and Position | Kyle Easton (REVENUE CYCLE DIRECTOR) |
| Authorized Official Contact | 6672607924 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chase Brexton Health Services, Inc. 1111 North Charles Street Baltimore MD 21201 Ph: (410) 837-2050 | Chase Brexton Health Services, Inc. 1111 North Charles Street Baltimore MD 21201 Ph: (410) 837-2050 |
| NPI Number | 1073637492 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 02/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073637492 | NPI | - | NPPES |
| 132190100 | Medicaid | MD | |
| 097004200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (Maryland) | Primary |
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