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NPI Code Detail

MEDICARE: PROVIDER PARTNERS CARE MANAGEMENT LP

MEDICARE: PROVIDER PARTNERS CARE MANAGEMENT LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2363L00000XNurse Practitioner

General Provider Information

NPI Number : 1013348028
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROVIDER PARTNERS CARE MANAGEMENT LP
Provider Business Mailing Address
First Line : 8820 COLUMBIA 100 PKWY STE 430
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2175
Country : US
Telephone Number : 410-967-2097
Fax Number :
Provider Business Practice Location Address
First Line : 8820 COLUMBIA 100 PKWY STE 430
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2175
Country : US
Telephone Number : 443-275-9800
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : KEITH D PERSINGER
Credential :
Telephone Number : 443-275-9800
Provider Enumeration Date : 12/02/2013
Last Update Date : 07/29/2025

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Directions to “PROVIDER PARTNERS CARE MANAGEMENT LP ” Practice Location

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