Provider Demographics
NPI:1386690790
Name:HELIXCARE MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:HELIXCARE MEDICAL GROUP, LLC
Other - Org Name:MEDSTAR PHYSICIAN PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING ASSOCIATE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEELE-WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-933-3073
Mailing Address - Street 1:9600 PULASKI PARK DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1400
Mailing Address - Country:US
Mailing Address - Phone:410-574-3000
Mailing Address - Fax:410-574-2261
Practice Address - Street 1:5601 LOCH RAVEN BLVD
Practice Address - Street 2:RUSSELL MORGAN BLDG., SUITE 206
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2905
Practice Address - Country:US
Practice Address - Phone:443-444-5600
Practice Address - Fax:443-444-4606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD366AOtherCAREFIRST OF MD
MD511000933Medicaid
MDA732OtherCAREFIRST DC
MDCC3132OtherRAILROAD MEDICARE
MDW652OtherCAREFIRST DC
MDW651OtherCAREFIRST DC
MDW653OtherCAREFIRST DC
MD511000926Medicaid
MDW611OtherCAREFIRST DC
MAW655OtherCAREFIRST DC
MD511000900Medicaid
MD511000902Medicaid
MD511000903Medicaid
MDKT80OtherCAREFIRST OF MD
MD511000903Medicaid