| NPI | 1083966055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN ROBERT EDGECOMBE Physician 301-868-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0023826) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2012-10-15 |