| Dr. Tamader H. Mira, P.a. | |
|
5505 Ritchie Hwy E Brooklyn MD 21225-3444 | |
| (410) 355-0340 | |
| (410) 636-3403 |
| Full Name | Dr. Tamader H. Mira, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5505 Ritchie Hwy, Brooklyn, Maryland |
| Authorized Official Name and Position | Tamader Mira (PRESIDENT) |
| Authorized Official Contact | 4104404827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Tamader H. Mira, P.a. 5505 Ritchie Hwy E Brooklyn MD 21225-3444 Ph: (410) 355-0340 | Dr. Tamader H. Mira, P.a. 5505 Ritchie Hwy E Brooklyn MD 21225-3444 Ph: (410) 355-0340 |
| NPI Number | 1508830829 |
|---|---|
| Provider Enumeration Date | 02/14/2006 |
| Last Update Date | 12/26/2021 |
| Medicare PECOS PAC ID | 8729161484 |
|---|---|
| Medicare Enrollment ID | O20080219000261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508830829 | NPI | - | NPPES |
| 912081500 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Maryland) | Primary |
| Provider Name | Tamader H Mira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023205887 PECOS PAC ID: 4880777549 Enrollment ID: I20080327000302 |
| Provider Name | Letitia J Wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992987499 PECOS PAC ID: 8022162056 Enrollment ID: I20090811000036 |
| Provider Name | Daniella Villaran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972231462 PECOS PAC ID: 8123486925 Enrollment ID: I20230627001913 |
Total Health Care Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3540 S Hanover St, Brooklyn, MD 21225 Phone: 410-383-8300 Fax: 410-383-3160 | |
Family Health Centers Of Baltimore, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3540 S Hanover St, Brooklyn, MD 21225 Phone: 410-355-0343 Fax: 410-355-5764 |