| Maryland Primary Care Clinic Llc | |
|
8114 Sandpiper Cir Ste 202 Baltimore MD 21236-5902 | |
| (352) 745-4398 | |
| Not Available |
| Full Name | Maryland Primary Care Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8114 Sandpiper Cir Ste 202, Baltimore, Maryland |
| Authorized Official Name and Position | Lata Pradhan (NP) |
| Authorized Official Contact | 3527454398 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Primary Care Clinic Llc 8114 Sandpiper Cir Ste 202 Baltimore MD 21236-5902 Ph: (352) 745-4398 | Maryland Primary Care Clinic Llc 8114 Sandpiper Cir Ste 202 Baltimore MD 21236-5902 Ph: (352) 745-4398 |
| NPI Number | 1417717539 |
|---|---|
| Provider Enumeration Date | 03/19/2024 |
| Last Update Date | 03/19/2024 |
| Medicare PECOS PAC ID | 4981144169 |
|---|---|
| Medicare Enrollment ID | O20240914000357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417717539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dilli Poudel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568754786 PECOS PAC ID: 5597933093 Enrollment ID: I20150601000647 |
| Provider Name | Lata Shrestha Pradhan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497498927 PECOS PAC ID: 6709326986 Enrollment ID: I20240914000374 |
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