Provider Demographics
NPI:1679507297
Name:MARYLAND PULMONARY & CRITICAL CARE GROUP, P.A.
Entity Type:Organization
Organization Name:MARYLAND PULMONARY & CRITICAL CARE GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BATCHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-335-0008
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-1133
Practice Address - Street 1:1600 CRAIN HWY S
Practice Address - Street 2:SUITE 308
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5577
Practice Address - Country:US
Practice Address - Phone:410-760-5510
Practice Address - Fax:410-760-5925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD462971000Medicaid
MDKA95MAOtherCAREFIRST
DC3340OtherCAREFIRST
GACE8614OtherRAILROAD MEDICARE
GACE8614OtherRAILROAD MEDICARE