| NPI | 1700165818 |
|---|---|
| Doing Business As | REVOLUTION MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MARIE MARTIN Office Manager 410-942-1015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D 71586) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D 50806) |
| Enumeration Date | 2011-08-06 |
| Last Update Date | 2011-08-06 |