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General NPI Number Information
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NPI Number | 1548123862
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Entity Type | Organization
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Legal Business Name | MARYLAND ELDER CARE LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 2700 SOUTHAVEN RD
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7122
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Country | US
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Telephone | 410-349-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 542 FAIRMOUNT RD
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City | LINTHICUM
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State | MD
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Zip | 21090-2842
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Country | US
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Telephone | 410-995-7439
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEGAN GREY
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Credential | CRNP
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Telephone | 410-995-7439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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