Healthcare Provider Details

I. General information

NPI: 1114786985
Provider Name (Legal Business Name): M MANAGEMENT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 BRIGHTSEAT RD
HYATTSVILLE MD
20785-3738
US

IV. Provider business mailing address

6 E EAGER ST
BALTIMORE MD
21202-2506
US

V. Phone/Fax

Practice location:
  • Phone: 240-487-4400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KRYSTLE D BROWN
Title or Position: BILLING MANAGER
Credential:
Phone: 410-870-9380