| NPI | 1366074023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW WELIK CEO 240-424-0715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| 207R00000X Internal Medicine | |
| 213E00000X Podiatrist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |