| Northwest Chf Program | |
|
5401 Old Court Rd Randallstown MD 21133-5103 | |
| (410) 521-2200 | |
| Not Available |
| Full Name | Northwest Chf Program |
|---|---|
| Speciality | Internal Medicine |
| Location | 5401 Old Court Rd, Randallstown, Maryland |
| Authorized Official Name and Position | David Mccormick (AVP) |
| Authorized Official Contact | 4107014618 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Chf Program 5401 Old Court Rd Attn: Credentialing Randallstown MD 21133-5103 Ph: (410) 601-5524 | Northwest Chf Program 5401 Old Court Rd Randallstown MD 21133-5103 Ph: (410) 521-2200 |
| NPI Number | 1104924703 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 10/20/2021 |
| Certification Date | 10/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104924703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 03-004 (Maryland) | Primary |
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