| Parkville Medical Group Llc | |
|
1721 Belfast Rd Sparks MD 21152-9786 | |
| (410) 371-3373 | |
| Not Available |
| Full Name | Parkville Medical Group Llc |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 1721 Belfast Rd, Sparks, Maryland |
| Authorized Official Name and Position | Terry Lynn Stevenson (MANAGING MEMBER/PROVIDER) |
| Authorized Official Contact | 4103713373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkville Medical Group Llc 1721 Belfast Rd Sparks MD 21152-9786 Ph: (410) 371-3373 | Parkville Medical Group Llc 1721 Belfast Rd Sparks MD 21152-9786 Ph: (410) 371-3373 |
| NPI Number | 1962960229 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962960229 | NPI | - | NPPES |
| 605M957F | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
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