Provider Demographics
NPI:1215164140
Name:HELIXCARE MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:HELIXCARE MEDICAL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEELE-WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-933-3073
Mailing Address - Street 1:5009 HONEYGO CENTER DR
Mailing Address - Street 2:SUITE 216
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9828
Mailing Address - Country:US
Mailing Address - Phone:410-256-5858
Mailing Address - Fax:410-529-2431
Practice Address - Street 1:5009 HONEYGO CENTER DR
Practice Address - Street 2:SUITE 216
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9828
Practice Address - Country:US
Practice Address - Phone:410-256-5858
Practice Address - Fax:410-529-2431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD366AOtherCAREFIRST OF MD
MDCC3132OtherRAILROAD MEDICARE
MDW611OtherCAREFIRST OF DC
MDA732OtherCAREFIRST OF DC
MDKT80OtherCAREFIRST OF MD
MD089LMedicare PIN