Organization
MEDSTAR ACCOUNTABLE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC R WAGNER (EXECUTIVE VICE PRESIDENT)
(410) 772-6595
Entity
Organization
Contact information
Practice address
5565 STERRETT PLACE, 5TH FLOOR, COLUMBIA, MD 21044
(410) 722-6500
Mailing address
5565 STERRETT PLACE, 5TH FLOOR, COLUMBIA, MD 21044
(410) 722-6500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MD
207R00000X
Internal Medicine Physician
Primary
—
MD
208000000X
Pediatrics Physician
—
MD
208D00000X
General Practice Physician
—
MD
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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