| NPI | 1548284086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYSON R. LUCKENBAUGH Chief Financial Officer 410-970-2071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2016-04-01 |