Organization
GENESIS ELDER CARE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SHAPIRO (VICE PRESIDENT)
(410) 832-7790
Entity
Organization
Contact information
Practice address
6508 DEER POINTE DR STE A, SALISBURY, MD 21804
(410) 543-1957
(410) 543-2951
Mailing address
PO BOX 62946, BALTIMORE, MD 21264-2946
(410) 494-7607
(610) 925-7387
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C196800
ID
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
C196800
ID
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
C196800
ID
363A00000X
Physician Assistant
C196800
ID
363L00000X
Nurse Practitioner
C196800
ID
363LA2200X
Adult Health Nurse Practitioner
C196800
ID
363LG0600X
Gerontology Nurse Practitioner
C196800
ID
Other
Enumeration date
02/04/2013
Last updated
08/05/2019
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