Genesis Eldercare Physician Services LLC
Internal Medicine, Geriatric Medicine in Towson, MD. Organization (NPI-2).
NPI number1699280511
StatusActive
Last updated in NPPESAug 5, 2019
Details
- NPI
- 1699280511
- Entity type
- Organization (NPI-2)
- Legal business name
- Genesis Eldercare Physician Services LLC
- Organization subpart
- No
- Enumeration date
- Dec 14, 2017
- Last updated
- Aug 5, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RG0300X | Internal Medicine, Geriatric Medicine | – | IN | Yes |
| 207RG0300X | Internal Medicine, Geriatric Medicine | – | – |
Practice location
515 Fairmount AveTowson, MD 21286
Phone 410-832-7790
Mailing address
Po Box 62946Baltimore, MD 21264-2946
Phone 410-494-7607
Authorized official
Eric Shapiro
Vice President
4108327790
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