| NPI | 1770291023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD JOHN LUSCHINSKI Owner 443-225-6674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2024-02-01 |