| NPI | 1669881272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY HARRY PARKER CEO 410-440-0317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MD MH - 1474) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2019-01-29 |