| NPI | 1366710766 |
|---|---|
| Doing Business As | PHS OTOLARYNGOLOGY PMB200 |
| Entity Type | Organization |
| Authorized Contact | BEAU HIGGINBOTHAN Vice President/COO 410-368-3182 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DC HFD01-0212) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: DC HFD01-0212) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2018-02-01 |