| NPI | 1356155071 |
|---|---|
| Other Name | AUTUMAN LAKE GLEN BURNIE |
| Entity Type | Organization |
| Authorized Contact | KRYSTLE D BROWN Billing Manager 410-800-6251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology |
| 207RN0300X Internal Medicine, Nephrology | |
| Enumeration Date | 2025-02-04 |
| Last Update Date | 2025-02-20 |