| NPI | 1255337002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN MARIE DUDLEY Office Manager 410-312-5280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0061704) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2013-10-18 |