Organization
BROADMEAD MEDICAL SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLEY ANN HUBBERT CPC (MEDICAL BILLING/ACCOUNTING DEPT.)
(443) 578-8043
Entity
Organization
Contact information
Practice address
13801 YORK RD, COCKEYSVILLE, MD 21030-1825
(410) 527-1900
(410) 527-3516
Mailing address
13801 YORK RD, COCKEYSVILLE, MD 21030-1825
(410) 527-1900
(410) 527-3516
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6902000000
BLUECROSSBLUESHIELD
MD
Enumeration date
11/29/2005
Last updated
12/17/2009
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