Collaboration Agreement No:
9026
Confirmation No:
9026_4439C0005185
Section 1 - Physician Assistant Information
Confidential Information redacted.
Section 2 - Primary Practice Setting & Location:
Practice Type:
In Home Health Evaluation
Facility
Signify Health Medical Associates, PLLC
Address
1910 Towne Center Blvd. Ste 250
Annapolis
MD 21401
Is this the location where a copy of your collaboration agreement is on file? YES
A copy (paper or electronic) must be immediately available upon request by the Board.
Section 3 - Advanced Duties and Prescriptive and Dispensing Authority
1.Does this Collaboration Agreement include Advanced Duties?
NO
2. Does this Collaboration Agreement include prescriptive authority?
NO
3. Does this Collaboration Agreement include dispensing authority under a physician's active dispensing permit?
NO