Organization
MEDSTAR PHYSICIAN PARTNERS, INC
Active
Other names
Medlantic Healthcare Group
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KESSLER (MANAGER)
(443) 725-8762
Entity
Organization
Contact information
Practice address
9600 PULASKI PARK DR, SUITE 103, BALTIMORE, MD 21220-1400
(410) 574-3000
(410) 574-2261
Mailing address
9600 PULASKI PARK DR, SUITE 103, BALTIMORE, MD 21220-1400
(410) 574-3000
(410) 574-2261
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176
CAREFIRST DC
—
05
—
035476700
—
DC
01
—
1777
CAREFIRST DC
—
05
—
414263200
—
MD
01
—
4300
CAREFIRST DC
—
01
—
6003
CAREFIRST DC
—
01
—
7099
CAREFIRST DC
—
01
—
B016
CAREFIRST DC
—
01
—
DB8990
RAILROAD MEDICARE
—
01
—
J484
CAREFIRST DC
—
01
—
KF60ME
CAREFIRST MD
—
Enumeration date
05/11/2006
Last updated
07/18/2012
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