Provider Demographics
NPI:1619165909
Name:BELTWAY INTERNAL MEDICINE
Entity Type:Organization
Organization Name:BELTWAY INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:SCHENDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-918-0020
Mailing Address - Street 1:9114 PHILADELPHIA RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4345
Mailing Address - Country:US
Mailing Address - Phone:310-918-0020
Mailing Address - Fax:410-918-0024
Practice Address - Street 1:9114 PHILADELPHIA RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4345
Practice Address - Country:US
Practice Address - Phone:310-918-0020
Practice Address - Fax:410-918-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD39758207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD123PMedicare PIN