| NPI | 1174628580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGIE BURR Director Of Professional Fees 410-706-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-23 |