BRAVO HEALTH ADVANCED CARE CENTER, P.C. (NPI# 1902158678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902158678 |
| Entity Type | Organization |
| Organization Name | BRAVO HEALTH ADVANCED CARE CENTER, P.C. |
| Practice Address |
312 Martin Luther King Jr Blvd Baltimore MD 21201-1221 |
| Mailing Address |
312 Martin Luther King Jr Blvd Ste 200 Baltimore MD 21201-1221 |
| Practice Telephone | 4432787001 |
| Mailing Telephone | 4432787001 |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2018-04-13 |
| Authorized Official Name | DIRK WALES (PRESIDENT) |
| Authorized Official Telephone | 6152366162 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265674592 | Bravo Health Advanced Care Center, P.C. | Family Medicine | 1601 Chestnut St, Philadelphia, PA 19192-4071 | 2009-04-01 |
| Street Address |
312 MARTIN LUTHER KING JR BLVD |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21201-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730387796 | Shahzad Alam Usmani | Internal Medicine | 312 Martin Luther King Jr Blvd, Baltimore, MD 21201-1221 | 2007-07-10 |
| 1588115554 | Choice Pain and Rehabilitation Center | Physical Medicine & Rehabilitation | 312 Martin Luther King Jr Blvd, Suite 102, Baltimore, MD 21201-1221 | 2016-10-14 |
| 1568919793 | Transformation Health Psychiatric Rehabilitation Program | Community/Behavioral Health | 312 Martin Luther King Jr Blvd, Suite 103, Baltimore, MD 21201-1221 | 2016-09-06 |
| 1578928289 | White Marsh Healthcare & Physical Medicine,llc | Chiropractor | 312 Martin Luther King Jr Blvd, Baltimore, MD 21201-1221 | 2015-12-22 |
| 1336540921 | Mary Lynn Mcpherson | Pharmacist | 312 Martin Luther King Jr Blvd, Baltimore, MD 21201-1221 | 2014-09-15 |
| 1194139394 | Tolulope Lawson-john | Nurse Practitioner | 312 Martin Luther King Jr Blvd, 102, Baltimore, MD 21201-1221 | 2014-06-16 |
| 1700219656 | Renew-rebuild-rehabilitate Chiropractic Center, LLC | Chiropractor | 312 Martin Luther King Jr Blvd, Suite 100, Baltimore, MD 21201-1221 | 2013-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585470 | Meshref Ayed Alshehri | Student in an Organized Health Care Education/Training Program | 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-07-08 |
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1740817733 | Martha Kaitlyn Coghlan | Student in an Organized Health Care Education/Training Program | Ummc Ob/gyn, 22 S. Greene St., Baltimore, MD 21201 | 2020-03-27 |
| 1629606637 | Taylor Renee Kai | Student in an Organized Health Care Education/Training Program | University of Maryland, 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-03-27 |
| 1295362697 | Brittany A Oster | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street 6th Floor, Suite 300, Baltimore, MD 21201 | 2020-03-25 |
| 1346877735 | Kayvon Michael Mobarakeh | Student in an Organized Health Care Education/Training Program | University of Maryland Department of Anesthesiology, 22 S Greene St, S11c, Baltimore, MD 21201 | 2020-03-25 |
| 1598392284 | Zachary Allan Hagen | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, 6th Flr., Suite 200, Baltimore, MD 21201 | 2020-03-24 |
| 1700430055 | Jaime Semchuk | Student in an Organized Health Care Education/Training Program | 737 West Lombard, Baltimore, MD 21201 | 2019-07-25 |
| 1952861619 | Zachary Daniel Sanford | Student in an Organized Health Care Education/Training Program | 22 S Greene Street S8b12, Baltimore, MD 21201 | 2019-03-20 |
| 1114487840 | Spencer Sykes Lovegrove | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, Sixth Floor, Suite 200, Baltimore, MD 21201 | 2019-03-20 |
| Find all providers in zip 21201 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336140524 | George Hennawi | Family Medicine | 5601 Loch Raven, Russell Morgan, Baltimore, MD 21239 | 2005-08-10 |
| 1336217819 | James Paul Richardson | Family Medicine | 900 Caton Ave, Department of Medicine, Sixth Floor, Baltimore, MD 21229-5201 | 2006-12-01 |
| 1235217225 | Shari Miura Ling | Family Medicine | 3001 S Hanover St, Room Nm533, Baltimore, MD 21225-1233 | 2006-11-01 |
| 1912921453 | Karen A. Cousins | Family Medicine | 827 Linden Ave, Baltimore, MD 21201 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376735100 | Edger V Potter Jr Md Inc | Family Medicine | 12017 Fort Washington Rd, Fort Washington, MD 20744-6004 | 2007-08-15 |
| 1750595401 | Ted Eric Howe | Family Medicine | 18100 Slade School Rd, Sandy Spring, MD 20860-1313 | 2007-05-10 |
| 1265594493 | Andres Salazar | Family Medicine | 3621 Ligon Rd, Ellicott City, MD 21042-5238 | 2006-12-14 |
| 1497841563 | Farzana Ajmal | Family Medicine | 19731 Executive Park Cir, Germantown, MD 20874-2642 | 2006-10-05 |
| 1942391693 | Paul A. Devore Md PC | Family Medicine | 4203 Queensbury Rd, Hyattsville, MD 20781-1435 | 2006-09-27 |
| 1063445013 | Lifestyle Medical Center, Cheryl Brown-christopher M. D., Chartered | Family Medicine | 116 Defense Hwy Ste 200, Annapolis, MD 21401-7045 | 2006-07-09 |
| 1932135548 | Nagji J Sureja | Family Medicine | 4212 Ridge Rd, Westminster, MD 21157-7849 | 2006-06-24 |
| 1689612236 | Raman Tuli, Md, P.C. | Family Medicine | 10810 Darnestown Rd, Suite 202, Gaithersburg, MD 20878-2675 | 2006-06-04 |
| 1851346423 | Arvind D Desai | Family Medicine | 30 Corporate Center, 10440 Little Patuxent Parkway, Suite 300, Columbia, MD 21044-3648 | 2006-05-23 |
| 1134102775 | Cyrus Hamidi | Family Medicine | 913 Ridgebrook Rd, Suite 312, Sparks, MD 21152-9451 | 2005-11-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.