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Organization

CHARM CITY HEALTHCARE, L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PANKAJ KHETERPAL M.D. (OWNER)
(410) 335-0008
Entity
Organization

Contact information

Practice address
120 EASTERN BLVD, BALTIMORE, MD 21221-7020
(410) 687-8818
(410) 682-3989
Mailing address
20 HICKORY KNOLL CT, TIMONIUM, MD 21093-4745
(410) 335-0008
(410) 682-3989

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1026426040001
MEDICAL ASSISTANCE
PA
01
137523
MEDICARE
MD
01
1538345046
BRAVO HEALTH
MD
01
1538345046
MEDICAL ASSISTANCE
VA
01
1538345046
TRICARE NORTH REGION
01
30044355001
HEALTH NET FEDERAL SERVICES - TRICARE
SC
01
417399600
MEDICAL ASSISTANCE
MD
01
DO6030
RAILROAD MEDICARE
GA
01
N681
CAREFIRST
DC
Enumeration date
01/15/2008
Last updated
02/13/2025
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