| NPI | 1407013956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAMID EHSANI-SHISHVAN Medical Director 410-707-0847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0065701) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MD D0065701) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2025-10-21 |