Individual ProviderTagwa KhairalseedRadiologyAllopathic & Osteopathic PhysiciansPractice Address600 N Wolfe St, Baltimore, MD 21287(410) 955-5000(410) 933-6421PECOS EnrollmentBased on the most recent information from CMS, provider Tagwa Khairalseed is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1801201090Provider TypeIndividualFull NameKhairalseed, TagwaCredentialMDGenderFemaleSole ProprietorNoEnumeration Date6/25/2014Last Updated5/3/2019Contact InformationPractice LocationPractice Address600 N Wolfe St, Baltimore, MD 21287Phone(410) 955-5000FaxUnlisted FaxMailing LocationMailing Address9910 Franklin Square Dr # 2110, Baltimore, MD 21236-4902Phone(410) 933-6421FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseD87319MarylandProvider IdentifiersIDDescriptionIssuerIDD87319DescriptionOtherIssuerLICENSEMaryland