Healthcare Provider Details
I. General information
NPI: 1477992410
Provider Name (Legal Business Name): FERBET TAKE CARE HEALTH MARYLAND, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2013
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
900 N. WASHINGTON STREET
BALTIMORE MD
21205
US
IV. Provider business mailing address
1901 E VOORHEES ST MS 640
DANVILLE IL
61834-4509
US
V. Phone/Fax
- Phone: 855-925-4733
- Fax: 217-709-2345
- Phone: 855-925-4733
- Fax: 217-709-2345
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEBORAH
HEGG
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 855-925-4733