Basic Information
Provider Information
NPI: 1669036737
EntityType: 2
ReplacementNPI:  
OrganizationName: ADFINITAS HEALTH AT THE MERCY HOSPITAL PLLC
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Mailing Information
Address1: PO BOX 69231
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212649231
CountryCode: US
TelephoneNumber: 4439490814
FaxNumber: 4432926814
Practice Location
Address1: 271 CAREW ST
Address2:  
City: SPRINGFIELD
State: MA
PostalCode: 011042377
CountryCode: US
TelephoneNumber: 4137489000
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Other Information
ProviderEnumerationDate: 04/24/2019
LastUpdateDate: 08/09/2022
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AuthorizedOfficialLastName: MILLARD
AuthorizedOfficialFirstName: KAREN
AuthorizedOfficialMiddleName: ANN
AuthorizedOfficialTitleorPosition: DIRECTOR RCM
AuthorizedOfficialTelephone: 6077382182
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IsOrganizationSubpart: N
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NPICertificationDate: 08/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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