Philip Konits
Individual provider
Active NPI
Specialist · Finksburg, MD
NPI 1700852159 · NPPES record last updated Oct 24, 2007
Key facts
- NPI
- 1700852159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- D0024321 (MD)
- Practice address
- 2059 Baltimore Blvd
Finksburg, MD 21048-1301
- Phone
- (410) 876-5148
- NPI assigned
- Feb 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20090923000347 |
MD |
Practitioner - Hematology/Oncology
Practitioner - Internal Medicine |
2264588839 |
|
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|
| D0024321 | MD | MD | Specialist |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Specialist |
174400000X |
D0024321 |
MD |
Yes |
Addresses
Primary practice location
2059 Baltimore Blvd
Finksburg, MD 21048-1301
Mailing address
PO Box 309
Westminster, MD 21158-0309
Phone (410) 876-5149
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 1508086521 | Other | MD | NPI |