Organization
MEDICAL HEALTH GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH L WOLCOTT (PRACTICE ADMINISTRATOR)
(410) 369-1700
Entity
Organization
Contact information
Practice address
1415 S MOUNTAIN RD STE 100, JOPPA, MD 21085-3236
(410) 369-1699
(410) 369-1707
Mailing address
1415 S MOUNTAIN RD STE 100, JOPPA, MD 21085-3236
(410) 369-1699
(410) 369-1707
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0291801
UNITED HEALTH CARE
—
01
—
2977766006
CIGNA
—
01
—
W647
BLUE CHOICE
—
Enumeration date
01/23/2006
Last updated
02/19/2019
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