Provider Demographics
NPI:1902035868
Name:HELIXCARE MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:HELIXCARE MEDICAL GROUP, LLC
Other - Org Name:MEDSTAR PHYSICIAN PARTNERS AT OWINGS MILLS
Other - Org Type:Doing Business As
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 1:23 CROSSROADS DR
Mailing Address - Street 2:SUITE 325
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5420
Mailing Address - Country:US
Mailing Address - Phone:410-363-8777
Mailing Address - Fax:410-363-9631
Practice Address - Street 1:23 CROSSROADS DR
Practice Address - Street 2:SUITE 325
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5420
Practice Address - Country:US
Practice Address - Phone:410-363-8777
Practice Address - Fax:410-363-9631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD511000941Medicaid
MD089LMedicare PIN