| NPI | 1780644104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY ANSTINE Billing Manager 410-529-9311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0045568) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2013-04-10 |