| NPI | 1851726343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY D ADAMS Owner 301-770-2270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MD 12906) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: MD 12663) |
| 305R00000X Preferred Provider Organization (Licence: MD 13707) | |
| 305R00000X Preferred Provider Organization (Licence: MD 15459) | |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2013-09-04 |