NPI | 1104818871 |
---|---|
Entity Type | Organization |
Authorized Contact | JON JOSEPH BELLANTONI Managing Physician 443-643-4300 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: MD D0033079) |
Enumeration Date | 2005-08-18 |
Last Update Date | 2015-04-17 |