| Integrative Health Practices, Llc | |
|
9501 Old Annapolis Rd Ste 205 Ellicott City MD 21042-6336 | |
| (410) 715-5256 | |
| Not Available |
| Full Name | Integrative Health Practices, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 9501 Old Annapolis Rd Ste 205, Ellicott City, Maryland |
| Authorized Official Name and Position | William Rollow (OWNER) |
| Authorized Official Contact | 4107155256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Health Practices, Llc 9501 Old Annapolis Rd Ste 205 Ellicott City MD 21042-6336 Ph: (410) 648-2555 | Integrative Health Practices, Llc 9501 Old Annapolis Rd Ste 205 Ellicott City MD 21042-6336 Ph: (410) 715-5256 |
| NPI Number | 1033634530 |
|---|---|
| Provider Enumeration Date | 08/07/2017 |
| Last Update Date | 04/24/2023 |
| Medicare PECOS PAC ID | 2163798299 |
|---|---|
| Medicare Enrollment ID | O20171018000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033634530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lauren B Richter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366434227 PECOS PAC ID: 3779658018 Enrollment ID: I20080820000579 |
| Provider Name | William C Rollow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790929719 PECOS PAC ID: 2567601099 Enrollment ID: I20130613000444 |
| Provider Name | Bridgette Cian Provost |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932420809 PECOS PAC ID: 8820233836 Enrollment ID: I20130819000686 |
| Provider Name | Laurie A Booth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366745895 PECOS PAC ID: 4385902071 Enrollment ID: I20180102000799 |
| Provider Name | Alison Schepler Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801252929 PECOS PAC ID: 2466862859 Enrollment ID: I20220713000449 |
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