Basic Information
| Provider Information | |||||||||
| NPI: | 1801023460 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HELIXCARE MEDICAL GROUP, LLC | ||||||||
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| OtherOrganizationName: | METROPOLITAN MEDICAL ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5601 LOCH RAVEN BLVD | ||||||||
| Address2: | RUSSELL MORGAN BLDG., SUITE 206 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212392905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434445600 | ||||||||
| FaxNumber: | 4434444606 | ||||||||
| Practice Location | |||||||||
| Address1: | 5601 LOCH RAVEN BLVD | ||||||||
| Address2: | RUSSELL MORGAN BLDG., SUITE 206 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212392905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434445600 | ||||||||
| FaxNumber: | 4434444606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2009 | ||||||||
| LastUpdateDate: | 06/22/2009 | ||||||||
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| AuthorizedOfficialLastName: | STEELE-WHITE | ||||||||
| AuthorizedOfficialFirstName: | JAMIE | ||||||||
| AuthorizedOfficialMiddleName: | L. | ||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALING ASSOCIATE | ||||||||
| AuthorizedOfficialTelephone: | 4109333073 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | CC3132 | 01 | MD | RAILROAD MEDICARE | OTHER | W611 | 01 | MD | CAREFIRST OF DC | OTHER | 366A | 01 | MD | CAREFIRST OF MD | OTHER |