| NPI | 1306924170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY MARIE HICKMAN Billing Supervisor 410-392-6133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD D0036586) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-10-18 |