| NPI | 1679152763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA DUKES Owner 443-694-8208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 251B00000X Case Management |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-06 |