| Upper Crossroads Medical Group | |
|
2412 Baldwin Mill Rd Fallston MD 21047 | |
| (410) 557-9191 | |
| (410) 557-9191 |
| Full Name | Upper Crossroads Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 2412 Baldwin Mill Rd, Fallston, Maryland |
| Authorized Official Name and Position | Salvacion Garin Lazatin (PHYSICIAN/PARTNER) |
| Authorized Official Contact | 4105579191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upper Crossroads Medical Group 2412 Baldwin Mill Rd Fallston MD 21047 Ph: (410) 557-9191 | Upper Crossroads Medical Group 2412 Baldwin Mill Rd Fallston MD 21047 Ph: (410) 557-9191 |
| NPI Number | 1104290261 |
|---|---|
| Provider Enumeration Date | 11/30/2015 |
| Last Update Date | 11/30/2015 |
| Medicare PECOS PAC ID | 8224321401 |
|---|---|
| Medicare Enrollment ID | O20160726001284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104290261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Salvacion G Lazatin |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1740329283 PECOS PAC ID: 5294028486 Enrollment ID: I20160726001516 |
Murli N Mathur, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1305 Fallston Rd, Fallston, MD 21047 Phone: 410-877-8494 Fax: 410-877-8494 |