Provider Demographics
NPI:1447584875
Name:HELIXCARE MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:HELIXCARE MEDICAL GROUP, LLC
Other - Org Name:MEDSTAR PHYSICIAN PARTNERS
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING ASSOCIATE
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 1:9600 PULASKI PARK DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9600 PULASKI PARK DR
Practice Address - Street 2:SUITE 103
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21220-1400
Practice Address - Country:US
Practice Address - Phone:410-933-3073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD366AOtherCAREFIRST OF MD