Provider Demographics
NPI:1912030073
Name:TCMG PA
Entity Type:Organization
Organization Name:TCMG PA
Other - Org Name:TRUECARE MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO-PRIMARY OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHNAMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-288-5220
Mailing Address - Street 1:6730 HOLABIRD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21222-1700
Mailing Address - Country:US
Mailing Address - Phone:410-288-6226
Mailing Address - Fax:410-288-9048
Practice Address - Street 1:6730 HOLABIRD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222
Practice Address - Country:US
Practice Address - Phone:410-288-6226
Practice Address - Fax:410-288-9048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044793207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE268OtherFEDERAL BLUE SHIELD GRP#
MD825231OtherMAMSI-UNITED HEALTHCARE
MDKA70ALOtherBLUE SHEILD OF MD GRP #
MD124500700Medicaid
MDCC2620OtherMEDICARE RAILROAD GRP NUM
MDKA70ALOtherBLUE SHEILD OF MD GRP #
MD825231OtherMAMSI-UNITED HEALTHCARE