| Kinstead Provider Group, P.A. | |
|
400 E Pratt St Fl 8 Baltimore MD 21202-3180 | |
| (305) 998-0546 | |
| (305) 414-0848 |
| Full Name | Kinstead Provider Group, P.A. |
|---|---|
| Speciality | Family Medicine |
| Location | 400 E Pratt St Fl 8, Baltimore, Maryland |
| Authorized Official Name and Position | Vikram Deepak Bakhru (PRESIDENT) |
| Authorized Official Contact | 3059980546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kinstead Provider Group, P.A. 2332 Galiano St Fl 2 Coral Gables FL 33134-5402 Ph: (305) 998-0546 | Kinstead Provider Group, P.A. 400 E Pratt St Fl 8 Baltimore MD 21202-3180 Ph: (305) 998-0546 |
| NPI Number | 1568338473 |
|---|---|
| Provider Enumeration Date | 10/16/2025 |
| Last Update Date | 10/19/2026 |
| Certification Date | 10/19/2026 |
| Medicare PECOS PAC ID | 1850885104 |
|---|---|
| Medicare Enrollment ID | O20251213000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568338473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 363LF0000X | Nurse Practitioner - Family | () | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | () | Secondary |
| Provider Name | Anthony Romeo Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134741515 PECOS PAC ID: 0749660421 Enrollment ID: I20220712002591 |
| Provider Name | Linden M Spital |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710231899 PECOS PAC ID: 6406009737 Enrollment ID: I20250926004007 |
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