| Mdics Rehabilitative Services Llc | |
|
6934 Aviation Blvd Suite B Glen Burnie MD 21061-2593 | |
| (443) 949-0814 | |
| (443) 949-0825 |
| Full Name | Mdics Rehabilitative Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6934 Aviation Blvd, Glen Burnie, Maryland |
| Authorized Official Name and Position | Tim Delbrugge (CFO) |
| Authorized Official Contact | 3016938707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdics Rehabilitative Services Llc Po Box 69231 Baltimore MD 21264-9231 Ph: (443) 949-0814 | Mdics Rehabilitative Services Llc 6934 Aviation Blvd Suite B Glen Burnie MD 21061-2593 Ph: (443) 949-0814 |
| NPI Number | 1124313309 |
|---|---|
| Provider Enumeration Date | 06/15/2011 |
| Last Update Date | 01/12/2024 |
| Medicare PECOS PAC ID | 4981861903 |
|---|---|
| Medicare Enrollment ID | O20120202000749 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124313309 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ellen R Mcinerney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235176157 PECOS PAC ID: 8527951144 Enrollment ID: I20040205001267 |
| Provider Name | Reshma Modi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588775902 PECOS PAC ID: 2860452455 Enrollment ID: I20041018000944 |
| Provider Name | Chang B Choi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912907593 PECOS PAC ID: 5294796827 Enrollment ID: I20050621000685 |
| Provider Name | Muhammad A Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568575074 PECOS PAC ID: 6800814559 Enrollment ID: I20051110000695 |
| Provider Name | Sima Nourani Zenuz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740362904 PECOS PAC ID: 9638199565 Enrollment ID: I20051206000881 |
| Provider Name | Juachi I Mbah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659326411 PECOS PAC ID: 0345245759 Enrollment ID: I20060918000505 |
| Provider Name | Deborah A Stein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538214382 PECOS PAC ID: 3870692502 Enrollment ID: I20070621000252 |
| Provider Name | Babatunde Ajani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649367632 PECOS PAC ID: 7214907732 Enrollment ID: I20070828000447 |
| Provider Name | Maria P Villanueva |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679748800 PECOS PAC ID: 0648346882 Enrollment ID: I20080911000481 |
| Provider Name | Mohammad Munir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861506891 PECOS PAC ID: 6305942244 Enrollment ID: I20081111000027 |
| Provider Name | Edith Aniedobe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467641183 PECOS PAC ID: 5890834048 Enrollment ID: I20091201000018 |
| Provider Name | Amare Abebe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629109970 PECOS PAC ID: 3678606100 Enrollment ID: I20100804000064 |
| Provider Name | Jennifer Lee Riedinger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144265877 PECOS PAC ID: 8921140252 Enrollment ID: I20101123000066 |
| Provider Name | Getachew Tefferra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770625907 PECOS PAC ID: 6507950136 Enrollment ID: I20101213000632 |
| Provider Name | Summit Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942485321 PECOS PAC ID: 6406931674 Enrollment ID: I20110107000257 |
| Provider Name | Hung T Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669446548 PECOS PAC ID: 8224039482 Enrollment ID: I20110323000481 |
| Provider Name | Diana M Ng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982769931 PECOS PAC ID: 3577658970 Enrollment ID: I20110323000658 |
| Provider Name | Benorayehush B Weldetsadik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255579744 PECOS PAC ID: 6507049814 Enrollment ID: I20110324000256 |
| Provider Name | Kirandeep Kaur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073742102 PECOS PAC ID: 1153445143 Enrollment ID: I20110324000472 |
| Provider Name | Josjin Vazhappilly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851520936 PECOS PAC ID: 8820283583 Enrollment ID: I20110324000498 |
| Provider Name | Syed Khurram Mahboob |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1770760944 PECOS PAC ID: 8729102728 Enrollment ID: I20110324000528 |
| Provider Name | Patricia Oshodi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558516187 PECOS PAC ID: 9133250624 Enrollment ID: I20110616000521 |
| Provider Name | Jose G Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417907858 PECOS PAC ID: 6608861778 Enrollment ID: I20120120000542 |
| Provider Name | Erin M Mcenany |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710138102 PECOS PAC ID: 3476612581 Enrollment ID: I20120203000258 |
| Provider Name | Nicole A Morrison |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154616555 PECOS PAC ID: 5799944179 Enrollment ID: I20120302000616 |
| Provider Name | Stephanie A Joy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134425028 PECOS PAC ID: 0042495244 Enrollment ID: I20120307000024 |
| Provider Name | Carrie A Dana-evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548536675 PECOS PAC ID: 4183887540 Enrollment ID: I20120531000378 |
| Provider Name | Addisu M Temesgen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386971927 PECOS PAC ID: 4183812266 Enrollment ID: I20120625000642 |
| Provider Name | Michael J Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710245220 PECOS PAC ID: 9032374814 Enrollment ID: I20120629000017 |
| Provider Name | Raza Afzal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376679837 PECOS PAC ID: 9830244268 Enrollment ID: I20120808000199 |
| Provider Name | Milca A Kaplan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457611774 PECOS PAC ID: 7517113301 Enrollment ID: I20120810000040 |
| Provider Name | Himabindu Manneri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881976785 PECOS PAC ID: 0042469231 Enrollment ID: I20121003000535 |
| Provider Name | Yvonne Etenyi Fomengia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215286810 PECOS PAC ID: 0840449872 Enrollment ID: I20121005000452 |
| Provider Name | Aisha Alizai |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487906087 PECOS PAC ID: 8921259375 Enrollment ID: I20121112000159 |
| Provider Name | Warren Clifton Mccormick |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609127547 PECOS PAC ID: 7618129743 Enrollment ID: I20130104000407 |
| Provider Name | Karen Ann Cousins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912921453 PECOS PAC ID: 1456381474 Enrollment ID: I20130130000377 |
| Provider Name | Suela Kaba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730383571 PECOS PAC ID: 1557558814 Enrollment ID: I20130228000205 |
| Provider Name | Bosede M Adeleye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659629798 PECOS PAC ID: 5395980502 Enrollment ID: I20130318000115 |
| Provider Name | Arnulfo B Bonavente |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619973534 PECOS PAC ID: 7517154982 Enrollment ID: I20130424000034 |
| Provider Name | Kristyn L Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053355479 PECOS PAC ID: 5395740732 Enrollment ID: I20130621000549 |
| Provider Name | Yvette C Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417394750 PECOS PAC ID: 5991945305 Enrollment ID: I20130709000185 |
| Provider Name | Farida Amer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467685586 PECOS PAC ID: 3072757418 Enrollment ID: I20131007000248 |
| Provider Name | Ali M Yahya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013934181 PECOS PAC ID: 8022141803 Enrollment ID: I20131115000013 |
| Provider Name | Deborah Araya |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659445955 PECOS PAC ID: 2466520200 Enrollment ID: I20131217000106 |
| Provider Name | Farhana B Syed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629253430 PECOS PAC ID: 0648465799 Enrollment ID: I20140410001323 |
| Provider Name | Lorenzo Childress |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1073723987 PECOS PAC ID: 8729262258 Enrollment ID: I20140416000768 |
| Provider Name | Laurie B Gezelle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245429000 PECOS PAC ID: 2264514512 Enrollment ID: I20140509001004 |
| Provider Name | Emily Frances Sim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770744559 PECOS PAC ID: 9032365267 Enrollment ID: I20140620001857 |
| Provider Name | Eugene Thomas Manion |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003910324 PECOS PAC ID: 9537299797 Enrollment ID: I20140724000257 |
| Provider Name | Jennifer R Knode |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245237684 PECOS PAC ID: 5698890168 Enrollment ID: I20141030001145 |
| Provider Name | Heather Wallick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588908347 PECOS PAC ID: 5092969782 Enrollment ID: I20141104002349 |
| Provider Name | Nicole A Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316348915 PECOS PAC ID: 1759503170 Enrollment ID: I20141119001178 |
| Provider Name | Priscilla Benewaah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053715508 PECOS PAC ID: 6901128875 Enrollment ID: I20141203001658 |
| Provider Name | Melissa R Barksdale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174927461 PECOS PAC ID: 5890018105 Enrollment ID: I20141219000718 |
| Provider Name | Ivelisse Michel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952590630 PECOS PAC ID: 7618021064 Enrollment ID: I20150206000247 |
| Provider Name | Musu K Turay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659776417 PECOS PAC ID: 1658696885 Enrollment ID: I20150402001147 |
| Provider Name | Maria Rosario A De La Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942605936 PECOS PAC ID: 0143548156 Enrollment ID: I20150422001790 |
| Provider Name | Julia E Brandenburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053718726 PECOS PAC ID: 1557685138 Enrollment ID: I20150424000899 |
| Provider Name | Sheikh Shehzad Parviz |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346215621 PECOS PAC ID: 2466480934 Enrollment ID: I20150505000238 |
| Provider Name | Frances E Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285673368 PECOS PAC ID: 6507813359 Enrollment ID: I20150512000840 |
| Provider Name | Megan N Shroyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063726313 PECOS PAC ID: 5799979563 Enrollment ID: I20150513002136 |
| Provider Name | Ellen Cassidy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013982248 PECOS PAC ID: 3072558535 Enrollment ID: I20150514000593 |
| Provider Name | Yesha S Patel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871870535 PECOS PAC ID: 0749456739 Enrollment ID: I20150514001676 |
| Provider Name | Dana Theresa Bageon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417205949 PECOS PAC ID: 5799936738 Enrollment ID: I20150526001901 |
| Provider Name | Jameka W Riley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073794491 PECOS PAC ID: 9335224153 Enrollment ID: I20150527000206 |
| Provider Name | Kristal Gardiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912315375 PECOS PAC ID: 0749501609 Enrollment ID: I20150603001905 |
| Provider Name | Taana P Viviano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225061088 PECOS PAC ID: 5698785368 Enrollment ID: I20150716001205 |
| Provider Name | Bibi Ibadin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861800211 PECOS PAC ID: 3779703574 Enrollment ID: I20150818005330 |
| Provider Name | Boris A Frolov |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1780690107 PECOS PAC ID: 4688995160 Enrollment ID: I20151005002143 |
| Provider Name | Francisco A Daniels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205941796 PECOS PAC ID: 0648254698 Enrollment ID: I20151209002042 |
| Provider Name | Bridgette A Gillin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366815698 PECOS PAC ID: 2365744299 Enrollment ID: I20160108000686 |
| Provider Name | Virginia Noftsier |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598028649 PECOS PAC ID: 4284881053 Enrollment ID: I20160302000043 |
| Provider Name | Babak Amirshahi Shirazi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255649695 PECOS PAC ID: 1052553971 Enrollment ID: I20160302002395 |
| Provider Name | Dagobert Simo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144458217 PECOS PAC ID: 5799940060 Enrollment ID: I20160525002148 |
| Provider Name | Taiye T Oni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932430659 PECOS PAC ID: 8820232283 Enrollment ID: I20160609000804 |
| Provider Name | Aleyamma Mathew |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659307627 PECOS PAC ID: 4284820184 Enrollment ID: I20160628000518 |
| Provider Name | Jazab Sheikh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043655186 PECOS PAC ID: 8820232705 Enrollment ID: I20160707001622 |
| Provider Name | Shahana Karim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275591141 PECOS PAC ID: 6800067083 Enrollment ID: I20160713000341 |
| Provider Name | Nicole Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205283009 PECOS PAC ID: 8527352368 Enrollment ID: I20160803000042 |
| Provider Name | Kelly M Heyward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225487861 PECOS PAC ID: 0345535506 Enrollment ID: I20160826001092 |
| Provider Name | Grace D Emasealu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619279502 PECOS PAC ID: 6305005703 Enrollment ID: I20160907001804 |
| Provider Name | Adetimbo Adediran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679922298 PECOS PAC ID: 4082902937 Enrollment ID: I20161011000913 |
| Provider Name | Jorawar Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417132309 PECOS PAC ID: 9931223427 Enrollment ID: I20161115000134 |
| Provider Name | Sarah Caroline Bazyluk |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689123630 PECOS PAC ID: 7416237706 Enrollment ID: I20161202000130 |
| Provider Name | Emily Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124451133 PECOS PAC ID: 9335378421 Enrollment ID: I20161227001139 |
| Provider Name | Yeside Ojo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760934913 PECOS PAC ID: 6901187780 Enrollment ID: I20170110002756 |
| Provider Name | Lakshmi Chillakuru |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184810905 PECOS PAC ID: 0648330928 Enrollment ID: I20170216000959 |
| Provider Name | Harini Kanani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013925601 PECOS PAC ID: 0345343646 Enrollment ID: I20170222002468 |
| Provider Name | Ashley N Nnorom |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871967216 PECOS PAC ID: 8628370269 Enrollment ID: I20170301000008 |
| Provider Name | Wajahath Mohsini |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467637751 PECOS PAC ID: 5698834455 Enrollment ID: I20170310001510 |
| Provider Name | Tiffany L Oates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255884920 PECOS PAC ID: 4981988961 Enrollment ID: I20170313001297 |
| Provider Name | Vivian Duru |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447529904 PECOS PAC ID: 9931369402 Enrollment ID: I20170323000216 |
| Provider Name | Virginie Chebou Ngantchon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194764514 PECOS PAC ID: 9436176609 Enrollment ID: I20170324001255 |
| Provider Name | Hyunji Edward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316480171 PECOS PAC ID: 4082990494 Enrollment ID: I20170420000913 |
| Provider Name | Nashae Handy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760920144 PECOS PAC ID: 3476839796 Enrollment ID: I20170420001666 |
| Provider Name | Pamela J Ogeya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295185528 PECOS PAC ID: 6901191980 Enrollment ID: I20170516000401 |
| Provider Name | Tejaswi Reddy Vootla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164780011 PECOS PAC ID: 1153605506 Enrollment ID: I20170622002151 |
| Provider Name | Funmilayo Oluwole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780115345 PECOS PAC ID: 1759650468 Enrollment ID: I20170711002973 |
| Provider Name | Karen Vancamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003272840 PECOS PAC ID: 3375847155 Enrollment ID: I20170921000624 |
| Provider Name | Cecilia S Kim |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1841551439 PECOS PAC ID: 8729229661 Enrollment ID: I20171229000052 |
| Provider Name | Jessie Fuentes Leonard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487087664 PECOS PAC ID: 4880838341 Enrollment ID: I20180124000816 |
| Provider Name | Adediwura Ajadi Jolaoso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801312053 PECOS PAC ID: 6305106022 Enrollment ID: I20180129000229 |
| Provider Name | Chase Neitzke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730552118 PECOS PAC ID: 5799089017 Enrollment ID: I20180312000125 |
| Provider Name | Megan Mcgilvray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215973227 PECOS PAC ID: 6507869351 Enrollment ID: I20180406001600 |
| Provider Name | Chantal Tchoumba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962917864 PECOS PAC ID: 4385999523 Enrollment ID: I20180612002147 |
| Provider Name | Jesse Okonigbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013363670 PECOS PAC ID: 0840575387 Enrollment ID: I20180827000603 |
| Provider Name | Lelise Endale |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316367881 PECOS PAC ID: 3476803727 Enrollment ID: I20180906002288 |
| Provider Name | Carla Schell Bowling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013439561 PECOS PAC ID: 9133493216 Enrollment ID: I20180917000311 |
| Provider Name | Catherine Kigaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508184235 PECOS PAC ID: 3779771548 Enrollment ID: I20181017001650 |
| Provider Name | Leigh A Everett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902825417 PECOS PAC ID: 8123123619 Enrollment ID: I20181127001151 |
| Provider Name | Johanna Devine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801377304 PECOS PAC ID: 2668717380 Enrollment ID: I20181227000068 |
| Provider Name | Sharon Liu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750826038 PECOS PAC ID: 8224312509 Enrollment ID: I20190416000002 |
| Provider Name | Victoria Fatmata Koroma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245701333 PECOS PAC ID: 0345581450 Enrollment ID: I20190417002347 |
| Provider Name | Naureen Khan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841776531 PECOS PAC ID: 8325398340 Enrollment ID: I20190530000538 |
| Provider Name | Bibi Aysha Siddhika |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720264658 PECOS PAC ID: 9739467226 Enrollment ID: I20190729001054 |
| Provider Name | Juliet Chikaodili Azie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144576893 PECOS PAC ID: 9931358108 Enrollment ID: I20190731001330 |
| Provider Name | Anika Murray |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760544332 PECOS PAC ID: 6800813353 Enrollment ID: I20190812001899 |
| Provider Name | Seid Aminu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215334602 PECOS PAC ID: 3173815388 Enrollment ID: I20190821004486 |
| Provider Name | Christina J Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003382433 PECOS PAC ID: 3476893892 Enrollment ID: I20190826001346 |
| Provider Name | Nadia Koran Krause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841705720 PECOS PAC ID: 8022348838 Enrollment ID: I20190920002363 |
| Provider Name | Kuroush Aligholizadeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144734492 PECOS PAC ID: 2860754470 Enrollment ID: I20191029002663 |
| Provider Name | Katherine E Daugherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912464819 PECOS PAC ID: 4486997988 Enrollment ID: I20191219000508 |
| Provider Name | Dawn Christine Conklin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114966678 PECOS PAC ID: 7012109952 Enrollment ID: I20191226000128 |
| Provider Name | Oluwakemi F Balogun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962963389 PECOS PAC ID: 1951735091 Enrollment ID: I20200116000277 |
| Provider Name | Kwabena Asante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235602905 PECOS PAC ID: 6305175100 Enrollment ID: I20200225000262 |
| Provider Name | Syed A Ali |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447477716 PECOS PAC ID: 7618042151 Enrollment ID: I20200312001637 |
| Provider Name | Elizabeth Shank |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134512197 PECOS PAC ID: 7012237126 Enrollment ID: I20200326001049 |
| Provider Name | Soukeye Niang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881159093 PECOS PAC ID: 6406287358 Enrollment ID: I20200511001063 |
| Provider Name | Cynthia Safo-mensa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164011698 PECOS PAC ID: 6608283601 Enrollment ID: I20210318000049 |
| Provider Name | Embarka Chaib |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548796501 PECOS PAC ID: 8527336262 Enrollment ID: I20210623001131 |
| Provider Name | Olubunmi O Aiyegbusi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417558131 PECOS PAC ID: 2567863244 Enrollment ID: I20210701002499 |
| Provider Name | Millicent E Stettler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609452986 PECOS PAC ID: 5294137089 Enrollment ID: I20210716000003 |
| Provider Name | Ruby Parkzes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801486246 PECOS PAC ID: 8426462920 Enrollment ID: I20210901002130 |
| Provider Name | Solange Bih |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669736237 PECOS PAC ID: 2365832417 Enrollment ID: I20211203000007 |
| Provider Name | Holly Nilsson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295408581 PECOS PAC ID: 8628475670 Enrollment ID: I20220308000994 |
| Provider Name | Melissa Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750730222 PECOS PAC ID: 7618263021 Enrollment ID: I20220520000131 |
| Provider Name | Ashok Kumar Ahuja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508048778 PECOS PAC ID: 7113312356 Enrollment ID: I20220714004228 |
| Provider Name | Margaret Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033610746 PECOS PAC ID: 7618238551 Enrollment ID: I20221012003650 |
| Provider Name | Cyriac Nchang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427589878 PECOS PAC ID: 1254750193 Enrollment ID: I20221019001307 |
| Provider Name | Sharon Drummond |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023104783 PECOS PAC ID: 5395112973 Enrollment ID: I20221119000345 |
| Provider Name | Yuhana Gidey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861109373 PECOS PAC ID: 9234502832 Enrollment ID: I20230301002820 |
| Provider Name | Jacqueline Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851360192 PECOS PAC ID: 8224222039 Enrollment ID: I20230907002367 |
| Provider Name | Yolanda Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528641560 PECOS PAC ID: 7012363773 Enrollment ID: I20231101000703 |
| Provider Name | Sabrina Ngong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851854244 PECOS PAC ID: 7012241854 Enrollment ID: I20240318001479 |
| Provider Name | Suzette Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386258929 PECOS PAC ID: 5597135418 Enrollment ID: I20240509001703 |
| Provider Name | Kimberly A Longo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356091888 PECOS PAC ID: 4183009772 Enrollment ID: I20240621001773 |
| Provider Name | Kimberly Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982943551 PECOS PAC ID: 8224261268 Enrollment ID: I20240711000709 |
| Provider Name | Cynthia Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861249211 PECOS PAC ID: 1456882067 Enrollment ID: I20241008000523 |
| Provider Name | Michelle Leigh Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184456691 PECOS PAC ID: 9335671361 Enrollment ID: I20241016001015 |
| Provider Name | Malcolm Winkle |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1629574173 PECOS PAC ID: 1658733225 Enrollment ID: I20241212002300 |
| Provider Name | Emnet Yibeltal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952980245 PECOS PAC ID: 6204374945 Enrollment ID: I20250113001004 |
| Provider Name | Julie Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689469512 PECOS PAC ID: 6305364316 Enrollment ID: I20250527000070 |
| Provider Name | Olamide Odetoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306557830 PECOS PAC ID: 0446618557 Enrollment ID: I20250708000286 |
| Provider Name | Holland Laurin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871753202 PECOS PAC ID: 2860559606 Enrollment ID: I20251008004436 |
| Provider Name | Linda Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437674850 PECOS PAC ID: 0749546265 Enrollment ID: I20251126002529 |
| Provider Name | Victoria Oluwaseun Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093009748 PECOS PAC ID: 0042530586 Enrollment ID: I20251231001010 |
| Provider Name | Randi Nicole Bouchillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437888138 PECOS PAC ID: 5092299792 Enrollment ID: I20260320001095 |
| Provider Name | Kimberly Fern |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245535749 PECOS PAC ID: 1254507965 Enrollment ID: I20260527002533 |
1st Step Medical & 1st Step Greenmed, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 Crain Hwy S Ste 2, Glen Burnie, MD 21061 Phone: 410-582-8170 Fax: 866-401-0775 | |
University Of Maryland Community Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Hospital Drive, Ste 304, Glen Burnie, MD 21061 Phone: 410-553-8146 | |
Jhu - 7671 Quarterfield Rd - Provider Type 20 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7671 Quarterfield Rd, Glen Burnie, MD 21061 Phone: 410-457-3041 | |
Apex Healthcare Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7575 E Howard Rd, Glen Burnie, MD 21060 Phone: 410-768-8200 | |
Gelsimo A. Cruz, M.d. P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 300 Hospital Drive, Suite 230, Glen Burnie, MD 21061 Phone: 410-768-2700 Fax: 410-768-2701 | |
Horizon Medical Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7845 Oakwood Rd, Suite 105, Glen Burnie, MD 21061 Phone: 410-650-4100 Fax: 877-648-1188 | |
Dr. Bamba's Health And Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1406b Crain Hwy S Ste 308, Glen Burnie, MD 21061 Phone: 443-953-8255 |