Organization
ERICKSON HEALTH MEDICAL GROUP OF PENNSYLVANIA PC
Active
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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