Healthcare Provider Details

I. General information

NPI: 1548436702
Provider Name (Legal Business Name): HEALTHCARE CONSULTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 SURRATTS RD
CLINTON MD
20735-3353
US

IV. Provider business mailing address

PO BOX 465
LOTHIAN MD
20711-0465
US

V. Phone/Fax

Practice location:
  • Phone: 301-856-1660
  • Fax:
Mailing address:
  • Phone: 410-741-1808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0035206
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR097929
License Number StateMD

VIII. Authorized Official

Name: BETSY BLANK
Title or Position: OWNER
Credential:
Phone: 410-741-1808