Absolutecare Of Baltimore, Llc - Primary Care Clinic/Center in Baltimore, Maryland | ProviderWire

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Primary Care Clinic/Center
Maryland
Baltimore
Absolutecare Of Baltimore, Llc

Legal Business Name

Absolutecare Of Baltimore, Llc

NPI Number

1508295726

NPI Type

Organization

Enumeration Date

11/07/2013

Specialties

(Taxonomies)

Name

Primary Care Clinic/Center

Adult Health Nurse Practitioner

Family Medicine Physician

Internal Medicine Physician

Code

261QP2300X

363LA2200X

207Q00000X

207R00000X

Primary Taxonomy

Yes

No

No

No

Licenses

State

Maryland

Maryland

Maryland

License Number

R167803

D0071154

D53063

Contact
Information

Purpose

Mailing

Location

Address

10175 LITTLE PATUXENT PKWY STE 800

1040 PARK AVE

City

Columbia

Baltimore

State

MD

MD

Postal Code

21044-3401

21201

Country

US

US

Telephone Number

N/A

(443) 738-0300

Authorized Official

Name

Dr. Gregory Foti

Title or Position

VICE PRESIDENT AND SECRETARY

Telephone Number

(443) 738-0225

Identifiers

Identifier

780015100

01938969

780015101

Identifier State

MD

MD

MD

Identifier Issuer

Unknown

AMERIGROUP MCO

Unknown

Health Information Exchange

Endpoint Type

DIRECT

Endpoint

sdickerson@absolutecare.com

Endpoint Description

Unknown

Use

Unknown

Content Type

Unknown

Affiliation

N

Endpoint Location

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/31/2024

Provider Address

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