| NPI | 1801073754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA A EDMONDSON Biller/ Credentials 410-879-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD d0038048) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2008-01-23 |