Salvacion Garin Lazatin, MD
Individual provider Active NPI General Practice Physician · Fallston, MD
NPI 1740329283 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1740329283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- D19526 (MD)
- Practice address
- 2412 Baldwin Mill Rd
Fallston, MD 21047 - Phone
- (410) 557-9191
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 1972
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2412 Baldwin Mill Rd
Fallston, MD 21047-1349
Phone (410) 557-9191
Hospital & facility affiliations
- Umd Upper Chesapeake Medical Center
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 |
|---|---|---|---|---|
| I20160726001516 | MD | Practitioner - General Practice |
5294028486 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upper Crossroads Medical Group | General Practice | Current |
Accepting new patients |
Locations
2412 Baldwin Mill Rd
Fallston, MD 21047
Phone (410) 557-9191
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | D19526 | MD | Yes |
Addresses
Primary practice location
2412 Baldwin Mill Rd
Fallston, MD 21047
Mailing address
2412 Baldwin Mill Rd
Fallston, MD 21047
Phone (410) 557-9191
Other providers in Fallston, MD
- Chelsea Klein
- Jane Cassilly Knapp
- Theodore A Kozlowski
- Danielle Krastel
- Ellen Rachel Lancaster
- Jessica Lynn Lefler
- Robert Jason Lembach
- Lewis Chiropractic Center
- Howard Franklin Lewis
- Victoria Lynn Little
All providers in Fallston, MD · General Practice Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.