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General NPI Number Information
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NPI Number | 1285443689
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Entity Type | Organization
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Legal Business Name | CHARM CITY HEALTHCARE, L.L.C.
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Dates
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Enumeration Date | 01/01/2025
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Last Update Date | 01/01/2025
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Provider Practice Location Address
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Address Line | 2 MARKET PL
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City | DUNDALK
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State | MD
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Zip | 21222-4351
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Country | US
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Telephone | 410-284-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 223 EASTERN BLVD
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City | ESSEX
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State | MD
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Zip | 21221-6936
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Country | US
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Telephone | 410-687-8818
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PANKAJ KHETERPAL
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Credential | MD
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Telephone | 443-527-2760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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