Thea L Koltz (NPI# 1215328521, PAC ID# 8527386556) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1215328521 |
| PAC ID by PECOS | 8527386556 |
| Professional Enrollment ID | I20150423000148 |
| Full Name | Thea L Koltz |
| Organization Legal Name | GOLDBERG ROSENSTEIN KHAN AND FORMAN MD PA |
| Address |
7505 Osler Dr Suite 502 Towson MD 21204-7740 |
| Phone Number | 4102964210 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 5799851077 |
| Number of Group Practice Members | 18 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210002 | UNIVERSITY OF MARYLAND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 22 S Green St, Baltimore, MD 21201-1544 | 4103286704 | UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION |
| 23 Crossroads Dr, Owings Mills, MD 21117-5420 | 4103568656 | OUTPATIENT ANESTHESIA SERVICES PC |
| 1220 -c E Joppa Rd, 508 Endoscopy Center of North Baltimore LLC, Towson, MD 21286-5811 | 4102964210 | GOLDBERG ROSENSTEIN KHAN AND FORMAN MD PA |
| 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 | 4102964210 | GOLDBERG ROSENSTEIN KHAN AND FORMAN MD PA |
| Organization Legal Name | GOLDBERG ROSENSTEIN KHAN AND FORMAN MD PA |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael P Broussard | Certified Registered Nurse Anesthetist (crna) | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Joshua S Forman | Gastroenterology | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Jamie B Walters | Gastroenterology | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Aminur R Khan | Gastroenterology | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Andrew H Rosenstein | Gastroenterology | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Mary Grace Renfrow | Nurse Practitioner | Goldberg Rosenstein Khan and Forman Md Pa | 7600 Osler Dr, Towson, MD 21204-7735 |
| Donald W Anderson Jr. | Certified Registered Nurse Anesthetist (crna) | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Michelle H Duell | Certified Registered Nurse Anesthetist (crna) | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Neil D Goldberg | Gastroenterology | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Street Address |
7505 OSLER DR SUITE 502 |
| City | TOWSON |
| State | MD |
| Zip | 21204-7740 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashraf S Mostafa | Internal Medicine | 7505 Osler Dr, Suite 208, Towson, MD 21204-7738 | |
| Michael P Broussard | Certified Registered Nurse Anesthetist (crna) | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Joshua S Forman | Gastroenterology | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Jamie B Walters | Gastroenterology | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Aminur R Khan | Gastroenterology | Goldberg Rosenstein Khan and Forman Md Pa | 7505 Osler Dr, Suite 502, Towson, MD 21204-7740 |
| Jeremy S Pollock | Internal Medicine | University of Maryland St Joseph Medical Group LLC | 7505 Osler Dr, Suite 103, Towson, MD 21204-7737 |
| Maria Y Que | Obstetrics/gynecology | 7505 Osler Dr, Suite 209, Towson, MD 21204-7738 | |
| Jin Gu | Internal Medicine | 7505 Osler Dr, Suite 312, Towson, MD 21204-7740 | |
| Kate P Knott | Nurse Practitioner | University of Maryland St Joseph Medical Group LLC | 7505 Osler Dr, Suite 302, Towson, MD 21204-7738 |
| Neena Rao | Cardiovascular Disease (cardiology) | 7505 Osler Dr, Suite 206, Towson, MD 21204-7737 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sharen M.b. Bisson | Psychiatry | Osler Medical Ctr, Suite 7600, Towson, MD 21204 | |
| Vinod Lakhanpal | Ophthalmology | Katzen Medical Associates PC | 901 Dulaney Valley Rd, Suite 200, Towson, MD 21204-0603 |
| Kristen Reese | Clinical Psychologist | Medop Behavioral Health Associates of Maryland PC | 901 Dulaney Valley Rd, Suite 129, Towson, MD 21204-0614 |
| Brittney Elizabeth Ziskind | Clinical Psychologist | Medop Behavioral Health Associates of Maryland PC | 901 Dulaney Valley Rd, Towson, MD 21204-0614 |
| Shawna Mowrer | Clinical Psychologist | Medop Behavioral Health Associates of Maryland PC | 901 Dulaney Valley Rd, Towson, MD 21204-0614 |
| Tracy O Cress | Certified Registered Nurse Anesthetist | Warren H Macleod C R N A Pa | 901 Dulaney Valley Rd, Suite 220, Towson, MD 21204-0621 |
| Emily M. Samuelson | Psychologist, Clinical | 28 Allegheny Ave, Suite 1305, Towson, MD 21204-1379 | |
| Charlotte E Coates Wilkes | Psychiatry | 8417 Bellona Ln, Suite 102, Towson, MD 21204-2014 | |
| Adolfo L Lopez | Internal Medicine | 8415 Bellona Ln, Suite 109, Towson, MD 21204-2015 | |
| Tanya J Quille | Psychologist, Clinical | 8422 Bellona Ln, Suite 207, Towson, MD 21204-2057 | |
| Find all physicians in zip 21204 | |||
| City | TOWSON |
| Zip Code | 21204 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | TOWSON + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
Please comment or provide details below to improve the information on Thea L Koltz.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.