| Green Spring Internal Medicine, Llc | |
|
2360 W Joppa Rd Suite 210 Lutherville MD 21093-4624 | |
| (410) 583-2890 | |
| (410) 583-2891 |
| Full Name | Green Spring Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2360 W Joppa Rd, Lutherville, Maryland |
| Authorized Official Name and Position | Holly R. Dahlman (MEMBER) |
| Authorized Official Contact | 4106088964 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Spring Internal Medicine, Llc 2360 W Joppa Rd Suite 210 Lutherville MD 21093-4624 Ph: (410) 583-2890 | Green Spring Internal Medicine, Llc 2360 W Joppa Rd Suite 210 Lutherville MD 21093-4624 Ph: (410) 583-2890 |
| NPI Number | 1558310490 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1951305812 |
|---|---|
| Medicare Enrollment ID | O20060907000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558310490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D0054653 (Maryland) | Primary |
| Provider Name | Holly R Dahlman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962464552 PECOS PAC ID: 6204830169 Enrollment ID: I20060907000129 |
| Provider Name | Deanna Shapiro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518362441 PECOS PAC ID: 7911220306 Enrollment ID: I20141215002262 |
| Provider Name | Zachary Nayak |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861782187 PECOS PAC ID: 1850541160 Enrollment ID: I20160222000462 |
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