| Gastro Center Of Maryland Llc | |
|
7120 Minstrel Way Suite 100 Columbia MD 21045-5248 | |
| (410) 290-6677 | |
| Not Available |
| Full Name | Gastro Center Of Maryland Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7120 Minstrel Way, Columbia, Maryland |
| Authorized Official Name and Position | Rudra Rai (OWNER/ PRESIDENT) |
| Authorized Official Contact | 4102906677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastro Center Of Maryland Llc 7120 Minstrel Way Suite 100 Columbia MD 21045-5248 Ph: (410) 290-6677 | Gastro Center Of Maryland Llc 7120 Minstrel Way Suite 100 Columbia MD 21045-5248 Ph: (410) 290-6677 |
| NPI Number | 1164609111 |
|---|---|
| Provider Enumeration Date | 01/22/2008 |
| Last Update Date | 05/07/2010 |
| Medicare PECOS PAC ID | 7517972037 |
|---|---|
| Medicare Enrollment ID | O20060220000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164609111 | NPI | - | NPPES |
| 282701800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | D0044427 (Maryland) | Primary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | (* (Not Available)) | Secondary |
| Provider Name | Michael S Ballo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1780648550 PECOS PAC ID: 2163498239 Enrollment ID: I20040909000625 |
| Provider Name | Rudrajit M Rai |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346213824 PECOS PAC ID: 6002831773 Enrollment ID: I20060220000468 |
| Provider Name | Vincent E Sutliff |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205896727 PECOS PAC ID: 4284628736 Enrollment ID: I20070410000548 |
| Provider Name | Akintunde Koso-thomas |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1114033743 PECOS PAC ID: 9739104027 Enrollment ID: I20070502000596 |
| Provider Name | Colleen M Abell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528254232 PECOS PAC ID: 7618040189 Enrollment ID: I20090223000310 |
| Provider Name | Pia Prakash |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629395686 PECOS PAC ID: 0648568246 Enrollment ID: I20161014000748 |
| Provider Name | Joshua Rosenbloom |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871856310 PECOS PAC ID: 2466772751 Enrollment ID: I20180918000737 |
| Provider Name | Eduardo Castillo Del Castillo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275743221 PECOS PAC ID: 0143464149 Enrollment ID: I20190124000044 |
| Provider Name | Carl C Gable |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1942416011 PECOS PAC ID: 3779657556 Enrollment ID: I20190426001672 |
| Provider Name | Whitney Morgen Green Moomaw |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1477882363 PECOS PAC ID: 6305097197 Enrollment ID: I20190709000946 |
| Provider Name | Farzin Rashti |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255562492 PECOS PAC ID: 3577783257 Enrollment ID: I20211201002405 |
| Provider Name | Dabo Xu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649616301 PECOS PAC ID: 3577855600 Enrollment ID: I20220712001998 |
| Provider Name | Dhruv Lowe |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255771697 PECOS PAC ID: 9335486943 Enrollment ID: I20230616000367 |
| Provider Name | Alexander Mamunes |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205368891 PECOS PAC ID: 1052681715 Enrollment ID: I20230802000364 |
| Provider Name | Thi Khuc |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538692652 PECOS PAC ID: 7416376918 Enrollment ID: I20230829004515 |
Ethos Health Maryland 3 Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10840 Little Patuxent Pkwy, Columbia, MD 21044 Phone: 352-732-5590 Fax: 352-732-0292 | |
Lorien Dialysis, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6334 Cedar Ln, Columbia, MD 21044 Phone: 410-750-7500 | |
Premier Medical Group Of Maryland Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10705 Charter Dr Ste 420, Columbia, MD 21044 Phone: 410-709-7432 | |
Evergreen Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9710 Patuxent Woods Dr, Suite 200, Columbia, MD 21046 Phone: 301-575-8080 | |
Patient Care Md Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9650 Santiago Rd, Suite #110, Columbia, MD 21045 Phone: 410-992-7004 Fax: 410-992-1657 | |
First Medical Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8600 Snowden River Pkwy Ste 207, Columbia, MD 21045 Phone: 301-515-2901 | |
Dr Beams Medical Home Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10794 Hickory Ridge Rd, Columbia, MD 21044 Phone: 443-832-9260 |