| NPI | 1467327700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DEIBEL Executive Vice President/CFO 410-659-2905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant Surgical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-10-07 |