Healthcare Provider Details

I. General information

NPI: 1306660766
Provider Name (Legal Business Name): HEALTH FIRST MEDICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6334 CEDAR LN
COLUMBIA MD
21044-3898
US

IV. Provider business mailing address

PO BOX 6303
ELLICOTT CITY MD
21042-0303
US

V. Phone/Fax

Practice location:
  • Phone: 410-531-5300
  • Fax: 443-535-9180
Mailing address:
  • Phone: 410-992-7004
  • Fax: 443-535-9180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAKUNMALA GUPTA
Title or Position: MD
Credential: MD
Phone: 410-992-7004