| NPI | 1013754969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN HEITHAUS CFO 410-535-8236 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-07-10 |