Gateway Medical Practice Llc | |
7226 Lee Deforest Dr Suite 206 Columbia MD 21046-3239 | |
(443) 878-7087 | |
Not Available |
Full Name | Gateway Medical Practice Llc |
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Speciality | Internal Medicine |
Location | 7226 Lee Deforest Dr, Columbia, Maryland |
Authorized Official Name and Position | Iuliana Keta Selaru (OWNER) |
Authorized Official Contact | 4438787087 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Gateway Medical Practice Llc 7226 Lee Deforest Dr Suite 206 Columbia MD 21046-3239 Ph: () - | Gateway Medical Practice Llc 7226 Lee Deforest Dr Suite 206 Columbia MD 21046-3239 Ph: (443) 878-7087 |
NPI Number | 1588074645 |
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Provider Enumeration Date | 04/29/2014 |
Last Update Date | 04/29/2014 |
Identifier | Type | State | Issuer |
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1588074645 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | D0065430 (Maryland) | Primary |
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