NPI | 1114314150 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMAL FADUL Owner 301-345-4400 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MD D0053745) |
Enumeration Date | 2015-04-16 |
Last Update Date | 2015-04-16 |