| NPI | 1366736779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRIE L BALLENGER Administrator 301-899-5140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD DD36306) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0054991) |
| 207R00000X Internal Medicine (Licence: MD D0046312) | |
| 207R00000X Internal Medicine (Licence: MD D0019935) | |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2011-06-02 |