| NPI | 1255198214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM PELOT Chief Administrator Officer 410-543-7497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2024-03-05 |
| Last Update Date | 2025-07-22 |