# MEDSTAR ACCOUNTABLE CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528444890
- **Authorized official:** MR. ERIC R WAGNER (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (410) 772-6595

## Contact information

- **Practice address:** 5565 STERRETT PLACE, 5TH FLOOR, COLUMBIA, MD 21044
- **Practice address phone:** (410) 722-6500
- **Mailing address:** 5565 STERRETT PLACE, 5TH FLOOR, COLUMBIA, MD 21044
- **Mailing address phone:** (410) 722-6500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | MD | — |
| 207R00000X | Internal Medicine Physician | — | MD | Yes |
| 208000000X | Pediatrics Physician | — | MD | — |
| 208D00000X | General Practice Physician | — | MD | — |

## Other

- **Enumeration date:** 08/10/2015
- **Last updated:** 08/10/2015