DOUGLAS BAZEMORE

CHURCHVILLE, MD
NPI1972029007
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171W00000X Contractor
Additional Taxonomies305S00000X Point of Service
Enumeration Date2017-08-21
Last Update Date2022-07-21
Business Address
DOUGLAS BAZEMORE
3014 COOL BRANCH ROAD
CHURCHVILLE, MD 21028
Phone number: 443-617-7277
Mailing Address
DOUGLAS BAZEMORE
3014 COOL BRANCH RD
CHURCHVILLE, MD 21028-1002
Phone number: 443-617-7277