| NPI | 1386004000 |
|---|---|
| Former Legal Business Name | INTEGRATED WELLNESS MD, LLC |
| Entity Type | Organization |
| Authorized Contact | TAMMY MUIR Compliance Officer 410-910-5959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics | |
| 363AM0700X Physician Assistant, Medical | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2023-12-08 |