| NPI | 1861229049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT R LILLY CEO 301-663-6162 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2026-06-23 |