| NPI | 1871887893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRIE L BALLENGER Administrator 301-398-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |