Physician Compare National (NPI:1134114911)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1134114911
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4486785284
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100728000223
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COMMERFORD
	Individual professional last name
Provider First Name	CHRISTINE
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1979
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DAMIAN E BIRCHESS MD ET AL PTR CHRISTINE L COMMERFORD MD
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7214068014
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5411 OLD FREDERICK RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 18
	Group Practice or individual's line 2 address
City	BALTIMORE
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	212292195
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4107884800
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	210011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT AGNES HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	210048
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOWARD COUNTY GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y