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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