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Organization

ABSOLUTECARE OF BALTIMORE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GREGORY P FOTI JR. M.D. (VICE PRESIDENT AND SECRETARY)
(443) 738-0225
Entity
Organization

Contact information

Practice address
1040 PARK AVE, SUITE 200, BALTIMORE, MD 21201
(443) 738-0300
(443) 738-0301
Mailing address
10175 LITTLE PATUXENT PKWY STE 800, COLUMBIA, MD 21044-3401

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
D0071154
MD
207R00000X
Internal Medicine Physician
D53063
MD
261QP2300X
Primary Care Clinic/Center
Primary
363LA2200X
Adult Health Nurse Practitioner
R167803
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01938969
AMERIGROUP MCO
MD
05
780015100
MD
05
780015101
MD
Enumeration date
11/07/2013
Last updated
09/12/2025
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