Provider Demographics
NPI:1164725529
Name:HELIXCARE MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:HELIXCARE MEDICAL GROUP, LLC
Other - Org Name:MEDSTAR PHYSICIAN PARTNERS-SPECIALITS AT ST. MARY'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING/PAYOR SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE-WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-933-3073
Mailing Address - Street 1:28227 THREE NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20659-3239
Mailing Address - Country:US
Mailing Address - Phone:301-884-8161
Mailing Address - Fax:
Practice Address - Street 1:28227 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20659-3239
Practice Address - Country:US
Practice Address - Phone:301-884-8161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD185575Medicare PIN