| NPI | 1144872094 |
|---|---|
| Other Name | LIFEBRIDGE PEDIATRICS AT LOCH RAVEN |
| Entity Type | Organization |
| Authorized Contact | CHARLES B EFIRD Director 410-601-7019 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2022-01-28 |