| NPI | 1609055086 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | MALIK ABDULREHMAN AWAN Doctor 410-242-5350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2022-07-21 |