| NPI | 1851910855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA FERGUSON Provider 443-840-9478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 163W00000X Registered Nurse | |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2025-09-23 |