Healthcare Provider Details

I. General information

NPI: 1447487368
Provider Name (Legal Business Name): HELIXCARE MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 WILKENS AVE SUITE 100
BALTIMORE MD
21229-4848
US

IV. Provider business mailing address

4660 WILKENS AVE SUITE 100
BALTIMORE MD
21229-4848
US

V. Phone/Fax

Practice location:
  • Phone: 410-247-0782
  • Fax: 410-242-7819
Mailing address:
  • Phone: 410-247-0782
  • Fax: 410-242-7819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMIE L. STEELE-WHITE
Title or Position: CREDENTIALING ASSOCIATE
Credential:
Phone: 410-933-3073