BON SECOURS BALTIMORE PHYSICIAN GROUP LLC (NPI# 1457606196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457606196 |
| Entity Type | Organization |
| Organization Name | BON SECOURS BALTIMORE PHYSICIAN GROUP LLC |
| Other Organization Name | CARDIOLOGY |
| Practice Address |
2000 West Baltimore Street Phys Svcs Baltimore MD 21223 |
| Practice Telephone | 4103623603 |
| Mailing Telephone | 4103623603 |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2012-07-18 |
| Authorized Official Name | DR. SAMUEL L ROSS (CEO) |
| Authorized Official Telephone | 4103633000 |
| Authorized Official Credential | MD, MS |
| Is Organization Subpart | Y |
| Parent Organization Name | BON SECOURS HOSPITAL BALTIMORE INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CARDIOLOGY | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427313972 | Bon Secours Baltimore Physician Group LLC | Anesthesiology | 2000 West Baltimore Street; Phys Serv, Baltimore, MD 21223-1557 | 2012-07-11 |
| 1326303744 | Bon Secours Baltimore Physician Group LLC | Internal Medicine | 2000 W Baltimore St, Physician Services, Baltimore, MD 21223-1558 | 2012-07-11 |
| 1972862027 | Bon Secours Baltimore Physician Group LLC | General Practice | 1940 W Baltimore St, 3rd Floor, Baltimore, MD 21223-2245 | 2012-05-10 |
| Street Address |
2000 WEST BALTIMORE STREET PHYS SVCS |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174878821 | Bon Secours Baltimore Physician Group | Psychiatry & Neurology | 2000 West Baltimore Street, Physician Services, Baltimore, MD 21223 | 2012-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649743972 | Dominique Olivier | Nurse Practitioner | Bon Secours Hospital, 2000 West Baltimore Street, Baltimore, MD 21223 | 2019-01-09 |
| 1659858769 | Millicent Boa-amponsem | Registered Nurse | 907 Ramsay St, Baltimore, MD 21223 | 2018-07-20 |
| 1023527231 | University Psychological Center, Inc | Substance Abuse Rehabilitation Facility | 13-19 South Fulton Avenue, Baltimore, MD 21223 | 2017-09-20 |
| 1245766468 | University Psychological Center, Inc | Substance Abuse Rehabilitation Facility | 1208-10 James Street, Baltimore, MD 21223 | 2017-05-08 |
| 1750737599 | Natasia D Brown | Social Worker | 1501 W. Saratoga St., Baltimore, MD 21223 | 2016-05-11 |
| 1104298355 | Independence Foundation, Inc. | Community/Behavioral Health | 13 S. Carrollton Ave, Baltimore, MD 21223 | 2015-10-28 |
| 1588095087 | Jr Healthcare Associates Dba Baltimore Behavioral Health | Clinic/Center | 1101 W. Pratt St., Baltimore, MD 21223 | 2013-12-09 |
| 1639501448 | Behavioral Health Network LLC | Counselor | 1101 W. Pratt Street, Baltimore, MD 21223 | 2013-08-02 |
| 1790060317 | Bestcare Pharmacy, Inc | Pharmacy | 3061 Frederick Avenue, Baltimore, MD 21223 | 2011-10-14 |
| 1962631218 | Charles Key Cooper | Internal Medicine | 2401 W. Baltimore St, Baltimore, MD 21223 | 2009-07-08 |
| Find all providers in zip 21223 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285113704 | Lifebridge Community Physicians, Inc | Internal Medicine | 940 Madison Avenue First Floor, Baltimore, MD 27201 | 2018-08-07 |
| 1407119712 | Yitzhak Rosen | Internal Medicine | Sheikh Zayed - Echo Lab, 1800 Orleans Streeet, 4th Floor, Baltimore, MD 21287-0010 | 2012-06-21 |
| 1013206119 | Thorsten Martin Leucker | Internal Medicine | 4940 Eastern Ave Ste 2400, Baltimore, MD 21224-2735 | 2011-03-30 |
| 1003115387 | Tolulope Adesiyun Agunbiade | Internal Medicine | 3333 N Calvert St Ste Llo8, Baltimore, MD 21218 | 2011-03-25 |
| 1932401544 | Esther Sung Hee Pak | Internal Medicine | 4416 Laplata Ave, Apt A, Baltimore, MD 21211-1135 | 2010-12-02 |
| 1598990780 | Boon Yew Tan | Internal Medicine | 600 N Wolfe Street Carnegie 592, Baltimore, MD 21287-0001 | 2009-05-18 |
| 1548494529 | Mansoor Mozayan | Internal Medicine | 9105 Franklin Square Dr Ste 209, Baltimore, MD 21237-3958 | 2009-05-06 |
| 1083880876 | John Rickard | Internal Medicine | 301 Mason Lord Dr, Baltimore, MD 21224-3057 | 2008-05-01 |
| 1639362247 | Ramanather Sirithara, M.d., P.a. | Internal Medicine | 3001 Hanover St, Suite 334, Baltimore, MD 21225-1233 | 2007-08-27 |
| 1629128830 | Peter V Johnston | Internal Medicine | 600 N Wolfe Street Carnegie 568, Baltimore, MD 21287-0001 | 2007-01-11 |
| Find all providers in BALTIMORE | ||||
Please comment or provide details below to improve the information on BON SECOURS BALTIMORE PHYSICIAN GROUP LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.