| NPI | 1629815451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN HEITHAUS CFO 410-535-8236 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| 2086S0129X Surgery, Vascular Surgery | |
| 208800000X Urology | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-07-10 |