Provider Demographics
NPI:1306490883
Name:PRECISE TELEHEALTH INC
Entity type:Organization
Organization Name:PRECISE TELEHEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEROUAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-524-9871
Mailing Address - Street 1:22 W. PADONIA RD
Mailing Address - Street 2:STE C241
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093
Mailing Address - Country:US
Mailing Address - Phone:203-524-9871
Mailing Address - Fax:678-609-1300
Practice Address - Street 1:5306 OLD VIRGINIA STREET
Practice Address - Street 2:
Practice Address - City:URBANNA
Practice Address - State:VA
Practice Address - Zip Code:23175
Practice Address - Country:US
Practice Address - Phone:203-524-9871
Practice Address - Fax:678-609-1300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECISE TELEHEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-01
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty