| Ideal Option, PLLC | |
|
4128 Hayward Ave Baltimore MD 21215-4340 | |
| (877) 522-1275 | |
| (833) 888-7145 |
| Full Name | Ideal Option, PLLC |
|---|---|
| Speciality | Clinic/center |
| Location | 4128 Hayward Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Shannon Marie Bowden (CONTRACTING & CREDENTIALING MANAGER) |
| Authorized Official Contact | 5095709302 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Option, PLLC 500 Sw 7th St Ste A205 Renton WA 98057-2983 Ph: (877) 522-1275 | Ideal Option, PLLC 4128 Hayward Ave Baltimore MD 21215-4340 Ph: (877) 522-1275 |
| NPI Number | 1508645235 |
|---|---|
| Provider Enumeration Date | 09/22/2023 |
| Last Update Date | 04/15/2025 |
| Certification Date | 04/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508645235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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