MEDICARE: ALLCARE OF MARYLAND, 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	261QU0200X	Urgent Care Clinic/Center
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1568680213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLCARE OF MARYLAND, LLC

Provider Business Mailing Address
First Line	:	6955 OAKLAND MILLS RD
Second Line	:	SUITE N
City	:	COLUMBIA
State	:	MD
Zip	:	21045-5849
Country	:	US
Telephone Number	:	410-290-9990
Fax Number	:	410-290-9996

Provider Business Practice Location Address
First Line	:	9396D BALTIMORE NATIONAL PIKE
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2802
Country	:	US
Telephone Number	:	410-480-1990
Fax Number	:	410-630-1996

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. GEORGE SEDRAKYAN
Credential	:	MD
Telephone Number	:	410-290-9990

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	03/08/2017

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