| Family Health Centers Of Baltimore, Inc. | |
|
631 Cherry Hill Rd Baltimore MD 21225-1228 | |
| (410) 354-2000 | |
| (410) 354-3674 |
| Full Name | Family Health Centers Of Baltimore, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 631 Cherry Hill Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Paula B Mclellan (CEO) |
| Authorized Official Contact | 4103542001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Centers Of Baltimore, Inc. 631 Cherry Hill Rd Baltimore MD 21225-1228 Ph: (410) 354-2000 | Family Health Centers Of Baltimore, Inc. 631 Cherry Hill Rd Baltimore MD 21225-1228 Ph: (410) 354-2000 |
| NPI Number | 1205013539 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 03/18/2014 |
| Medicare PECOS PAC ID | 2961310651 |
|---|---|
| Medicare Enrollment ID | O20040126000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205013539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Maryland) | Primary |
| Provider Name | Fawn T Manning |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568457513 PECOS PAC ID: 4486649654 Enrollment ID: I20040416001325 |
| Provider Name | Michael R Smith |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1699942656 PECOS PAC ID: 9436299328 Enrollment ID: I20101227000251 |
| Provider Name | Vivian Archibong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235340266 PECOS PAC ID: 9931383239 Enrollment ID: I20110412000098 |
| Provider Name | Leia M Medlock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659531077 PECOS PAC ID: 1254587355 Enrollment ID: I20120806000326 |
| Provider Name | Yeside Ojo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760934913 PECOS PAC ID: 6901187780 Enrollment ID: I20170110002642 |
| Provider Name | Omeid Heidari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942702915 PECOS PAC ID: 2264797653 Enrollment ID: I20180606002081 |
| Provider Name | Sarah Musa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124777230 PECOS PAC ID: 9830561414 Enrollment ID: I20230208000180 |
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