Organization
GENESIS ELDERCARE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SHAPIRO (VP, AREA CONTROLLER)
(410) 832-7790
Entity
Organization
Contact information
Practice address
6508 DEER POINTE DR STE A, SALISBURY, MD 21804
(410) 543-1957
(410) 543-8492
Mailing address
PO BOX 62946, BALTIMORE, MD 21264-2946
(410) 494-7607
(610) 925-7387
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/28/2010
Last updated
08/05/2019
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