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1366739179
MARYLAND HEALING WATERS, LLC
GLEN BURNIE, MD
NPI
1366739179
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Entity Type
Organization
Authorized Contact
LAWRENCE VIDAVER
Physician
410-761-7901
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: MD d25559)
Enumeration Date
2011-06-30
Last Update Date
2024-05-17
Business Address
MARYLAND HEALING WATERS, LLC
1414 CRAIN HWY N STE 6A
GLEN BURNIE, MD 21061-9307
Phone number: 410-761-7901
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Mailing Address
MARYLAND HEALING WATERS, LLC
1414 CRAIN HWY N STE 6A
GLEN BURNIE, MD 21061-9307
Phone number: 410-761-7901
Copy
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