| NPI | 1255449260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROBERT NICHOLS Credentialing Representative 410-258-6333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2008-12-18 |