| NPI | 1104845361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE HERBERT BONE Owner 301-773-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D31069) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-10-25 |