| NPI | 1528013414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE THOMAS Ubo Manager 410-293-1166 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2025-05-29 |