Healthcare Provider Details

I. General information

NPI: 1508295726
Provider Name (Legal Business Name): ABSOLUTECARE OF BALTIMORE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 09/12/2025
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 PARK AVE SUITE 200
BALTIMORE MD
21201
US

IV. Provider business mailing address

10175 LITTLE PATUXENT PKWY STE 800
COLUMBIA MD
21044-3401
US

V. Phone/Fax

Practice location:
  • Phone: 443-738-0300
  • Fax: 443-738-0301
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0071154
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD53063
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR167803
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY P FOTI JR.
Title or Position: VICE PRESIDENT AND SECRETARY
Credential: M.D.
Phone: 443-738-0225