| NPI | 1821336959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE EASTON Revenue Cycle Director 410-837-2050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2025-03-05 |