| NPI | 1831112143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RICHARDS Credentialing Coordinator 301-493-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-06-17 |