| NPI | 1538973250 |
|---|---|
| Other Name | MFA SHADY GROVE |
| Entity Type | Organization |
| Authorized Contact | KRYSTLE D BROWN Billing Manager 410-800-6251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2025-02-04 |
| Last Update Date | 2025-02-04 |