MEDICARE: MARYLAND HEALTHCARE CLINICS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	111N00000X	Chiropractor
2	225100000X	Physical Therapist
3	225200000X	Physical Therapy Assistant
4	111NR0400X	Rehabilitation Chiropractor

General Provider Information

NPI Number	:	1518119205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARYLAND HEALTHCARE CLINICS

Provider Business Mailing Address
First Line	:	3301 BELAIR RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21213-1202
Country	:	US
Telephone Number	:	410-792-6110
Fax Number	:	410-732-6112

Provider Business Practice Location Address
First Line	:	3301 BELAIR RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21213-1202
Country	:	US
Telephone Number	:	410-792-6110
Fax Number	:	410-732-6112

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. ROMAN BALAKIRSKY BALAKIRSKY
Credential	:
Telephone Number	:	410-318-6253

Provider Enumeration Date	:	10/14/2008
Last Update Date	:	10/14/2008

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Directions to “MARYLAND HEALTHCARE CLINICS ” Practice Location

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