MEDICARE: GRACEWAY HEALTH CARE LLC

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1134076359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEWAY HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	115 E MELROSE AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21212-2945
Country	:	US
Telephone Number	:	410-435-9073
Fax Number	:

Provider Business Practice Location Address
First Line	:	10259 CABERY RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-1605
Country	:	US
Telephone Number	:	410-870-9380
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	ADDISU M. TEMESGEN
Credential	:	MD
Telephone Number	:	410-435-9073

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/27/2026

Similar Medicare Providers

1982609160 — E MEDICAL GROUP, INC
Practice Location Address:

1605 7TH ST STE A
BAY CITY, TX
77414-5013

Practice Phone: 979-244-0600
Practice Fax: 979-244-4505

1609837368 — MARK O. CARLSON M.D.
Practice Location Address:

1605 DOUGLAS ST
SIOUX CITY, IA
51105-1109

Practice Phone: 712-234-1005
Practice Fax: 712-234-0015

1063436277 — DR. JEANNE M MCGREGOR M.D., M.P.H.
Practice Location Address:

1605 THONOTOSASSA RD
PLANT CITY, FL
33563-4251

Practice Phone: 813-707-0200
Practice Fax: 813-717-7701

1629085923 — DR. ALAN DREW MEILSTRUP DDS
Practice Location Address:

1409 W 1000 N
SALT LAKE CITY, UT
84116-1605

Practice Phone: 801-595-1313
Practice Fax:

1760492227 — MS. MARGARET THERESA MARLAND LPC
Practice Location Address:

819 E 72ND ST
KANSAS CITY, MO
64131-1605

Practice Phone: 816-361-8065
Practice Fax:

1871686246 — FOOD LION LLC
Practice Location Address:

1605 E 11TH ST
SILER CITY, NC
27344-2823

Practice Phone: 919-742-9969
Practice Fax: 919-742-9978

Directions to “GRACEWAY HEALTH CARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.