| NPI | 1285208025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY LONG Chief Administrative Officer&Genera 443-949-0814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2021-05-17 |