Blackwater Medical Associates, Llc

LBN: Blackwater Medical Associates, Llc
Blackwater Medical Associates, Llc is an health care organization with primary practice located at 408 Byrn St , Cambridge MD 21613-1910. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Blackwater Medical Associates, Llc can be contacted via phone (410) 228-1068, or through Malkus, Mark M via phone (410) 228-1068.

Contact Information

Primary practice address
408 Byrn St Cambridge MD 21613-1910
Phone: (410) 228-1068
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Malkus, Mark M Doctor of Medicine (MD)
Phone: (410) 228-1068

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D0050804 Maryland

Profile Details

NPI number 1508986092
LBN Legal business name Blackwater Medical Associates, Llc
DBA Doing business as
Authorized official Malkus, Mark M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 30th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508986092 NPPES
Maryland MEDICAID 7810000800

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