Organization
MARYLAND SPINE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK INGRAM DC (OWNER)
(410) 833-3038
Entity
Organization
Contact information
Practice address
517 MAIN STREET, REISTERSTOWN, MD 21136
(410) 833-3038
(410) 833-3039
Mailing address
517 MAIN STREET, REISTERSTOWN, MD 21136
(410) 833-3038
(410) 833-3039
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
03384
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
280BMA
CAREFIRST MD
MD
01
—
62538403
CAREFIRST MD
MD
01
—
K0480001
BLUE CHOICE
MD
Enumeration date
10/04/2006
Last updated
08/22/2020
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