| Mafot & Associates Medical Services Llc | |
|
1403 Madison Park Dr Ste 200 Glen Burnie MD 21061-6427 | |
| (410) 487-6902 | |
| (410) 487-6982 |
| Full Name | Mafot & Associates Medical Services Llc |
|---|---|
| Speciality | General Practice |
| Location | 1403 Madison Park Dr Ste 200, Glen Burnie, Maryland |
| Authorized Official Name and Position | Dagobert Simo (DIRECTOR) |
| Authorized Official Contact | 2404321924 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mafot & Associates Medical Services Llc 11183 Columbia Pike Silver Spring MD 20901-4507 Ph: () - | Mafot & Associates Medical Services Llc 1403 Madison Park Dr Ste 200 Glen Burnie MD 21061-6427 Ph: (410) 487-6902 |
| NPI Number | 1104248541 |
|---|---|
| Provider Enumeration Date | 01/18/2014 |
| Last Update Date | 08/31/2022 |
| Medicare PECOS PAC ID | 8921226069 |
|---|---|
| Medicare Enrollment ID | O20140902001633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104248541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | D0073466 (Maryland) | Primary |
| Provider Name | Dagobert Simo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144458217 PECOS PAC ID: 5799940060 Enrollment ID: I20120712000166 |
| Provider Name | Armel Simo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376708321 PECOS PAC ID: 9335319656 Enrollment ID: I20140325000124 |
| Provider Name | Carole K Simo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114599560 PECOS PAC ID: 7113325044 Enrollment ID: I20220104001753 |
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