Organization
ERICKSON HEALTH MEDICAL GROUP OF PENNSYLVANIA PC
Active
Other names
Maris Grove Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW J NARRETT MD (SENIOR VP AND CHIEF MEDICAL OFFICER)
(410) 402-2257
Entity
Organization
Contact information
Practice address
100 MARIS GROVE WAY, GLEN MILLS, PA 19342
(610) 387-4520
(610) 387-4526
Mailing address
5730 EXECUTIVE DR STE 230, CATONSVILLE, MD 21228-1762
(610) 387-4520
(610) 387-4526
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
213E00000X
Podiatrist
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
364SG0600X
Gerontology Clinical Nurse Specialist
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-24638
EVERCARE
—
01
—
2045582
HIGHMARK BS
—
01
—
2055830
HIGHMARK BLUE SHIELD
—
01
—
2055836
HIGHMARK BLUE SHIELD PODIATRISTS
—
01
—
22-55915002
KEYSTONE
—
01
—
758848
BCBS OF PA
—
Enumeration date
08/09/2006
Last updated
08/10/2023
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