NPI | 1962013748 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW WELIK CEO 301-928-5012 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery |
Additional Taxonomies | 207N00000X Dermatology |
207R00000X Internal Medicine | |
213E00000X Podiatrist | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2020-08-13 |
Last Update Date | 2020-08-13 |