| NPI | 1316731573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA L BAZEMORE QUAYE Administrator 443-636-0686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology |
| Enumeration Date | 2025-04-04 |
| Last Update Date | 2025-04-04 |