Basic Information
| Provider Information | |||||||||
| NPI: | 1821622838 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CIRCLES HEALTHCARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9218 WOODCREEK CT | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212341544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4432258283 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2480 ROXBURY MILLS RD STE 10 | ||||||||
| Address2: | |||||||||
| City: | GLENWOOD | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217389718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4432258283 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2020 | ||||||||
| LastUpdateDate: | 03/31/2020 | ||||||||
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| AuthorizedOfficialLastName: | FLYNN | ||||||||
| AuthorizedOfficialFirstName: | SOPHIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4432258283 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | FNP-BC | ||||||||
| NPICertificationDate: | 03/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.