Healthcare Provider Details

I. General information

NPI: 1568680213
Provider Name (Legal Business Name): ALLCARE OF MARYLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9396D BALTIMORE NATIONAL PIKE
ELLICOTT CITY MD
21042-2802
US

IV. Provider business mailing address

6955 OAKLAND MILLS RD SUITE N
COLUMBIA MD
21045-5849
US

V. Phone/Fax

Practice location:
  • Phone: 410-480-1990
  • Fax: 410-630-1996
Mailing address:
  • Phone: 410-290-9990
  • Fax: 410-290-9996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE SEDRAKYAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 410-290-9990