NPI | 1285760199 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY FOSTER Office Manager 301-540-5900 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MD D0055283) |
Additional Taxonomies | 174400000X Specialist (Licence: MD D0057921) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2013-03-14 |