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1841902004
WELLINGTON PROVIDER GROUP PC
BALTIMORE, MD
NPI
1841902004
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Entity Type
Organization
Authorized Contact
MARIELA BRAVO
Credentialing Team Lead
859-518-8817
Organization Subpart ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2022-12-20
Last Update Date
2022-12-20
Business Address
WELLINGTON PROVIDER GROUP PC
145 W OSTEND ST STE 600
BALTIMORE, MD 21230-3774
Phone number: 859-518-8817
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Mailing Address
WELLINGTON PROVIDER GROUP PC
535 WELLINGTON WAY STE 330
LEXINGTON, KY 40503-1331
Phone number: 859-518-8817
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