| NPI | 1346308962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA D BAKER Executive Director 410-838-0179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD A1013) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD A1017) |
| 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD A1014) | |
| 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD A1015) | |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2021-08-19 |