NPI | 1508295726 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY P FOTI Vice President And Secretary 443-738-0225 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0071154) |
207R00000X Internal Medicine (Licence: MD D53063) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: MD R167803) | |
Enumeration Date | 2013-11-07 |
Last Update Date | 2024-10-31 |