Provider Demographics
NPI:1306660766
Name:HEALTH FIRST MEDICAL CARE LLC
Entity type:Organization
Organization Name:HEALTH FIRST MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAKUNMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-992-7004
Mailing Address - Street 1:PO BOX 6303
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-0303
Mailing Address - Country:US
Mailing Address - Phone:410-992-7004
Mailing Address - Fax:443-535-9180
Practice Address - Street 1:6334 CEDAR LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3898
Practice Address - Country:US
Practice Address - Phone:410-531-5300
Practice Address - Fax:443-535-9180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD241500300Medicaid