| NPI | 1104205764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD P. COSTLOW President 410-561-1585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0019503) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |