Provider Demographics
NPI:1043202591
Name:PRICE, MICHELLE Y (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:Y
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:D
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7580 BUCKINGHAM BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-3210
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:
Practice Address - Street 1:5900 WATERLOO RD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2641
Practice Address - Country:US
Practice Address - Phone:410-740-2900
Practice Address - Fax:410-992-0732
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050778207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD80117369OtherRR MEDICARE
MD1454492OtherCIGNA PIN
MDP13465OtherCAREFIRST MPOS
MD021983OtherJHHC PROVIDER NUMBER
MD267853OtherMAMSI SPECIALIST
MD5164715OtherAETNA FEE FOR SERVICE
MD2106808OtherAETNA CAPITATED
MD3509-0011OtherCAREFIRST BLUECHOICE
MD546577-02OtherCAREFIRST MD RENDERING
MD759950100Medicaid
MD867853OtherMAMSI PRIMARY CARE
MD267853OtherMAMSI SPECIALIST
MD3509-0011OtherCAREFIRST BLUECHOICE