Wellington Provider Group PC
Family Medicine in Baltimore, MD. Organization (NPI-2).
Details
- NPI
- 1841902004
- Entity type
- Organization (NPI-2)
- Legal business name
- Wellington Provider Group PC
- Organization subpart
- Yes
- Enumeration date
- Dec 20, 2022
- Certification date
- Dec 20, 2022
- Last updated
- Dec 20, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
145 W Ostend St Ste 600Baltimore, MD 21230-3774
Phone 859-518-8817 · Fax 859-201-1084
Mailing address
535 Wellington Way Ste 330Lexington, KY 40503-1331
Phone 859-518-8817 · Fax 859-201-1084
Authorized official
Mariela Bravo
Credentialing Team Lead
8595188817
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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