Provider Demographics
NPI:1376739409
Name:BALTIMORE CLINICAL CARE ASSOCIATES INC
Entity Type:Organization
Organization Name:BALTIMORE CLINICAL CARE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:KHIN
Authorized Official - Middle Name:WIN
Authorized Official - Last Name:MYINT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-321-8580
Mailing Address - Street 1:6701 N CHARLES ST
Mailing Address - Street 2:SUITE 5100
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6808
Mailing Address - Country:US
Mailing Address - Phone:410-321-8580
Mailing Address - Fax:
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:SUITE 5100
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:410-321-8580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H14872Medicare UPIN
MD880LMedicare PIN