Queen Anne's Medical Center, Llc | |
2108 Rear Didonato Drive Chester MD 21619 | |
(410) 643-6205 | |
(410) 643-6945 |
Full Name | Queen Anne's Medical Center, Llc |
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Speciality | Internal Medicine |
Location | 2108 Rear Didonato Drive, Chester, Maryland |
Authorized Official Name and Position | Gary John Sprouse (PHYSICIAN) |
Authorized Official Contact | 4106436710 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Queen Anne's Medical Center, Llc 2108 Rear Didonato Drive Chester MD 21619 Ph: (410) 643-6710 | Queen Anne's Medical Center, Llc 2108 Rear Didonato Drive Chester MD 21619 Ph: (410) 643-6205 |
NPI Number | 1407359532 |
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Provider Enumeration Date | 03/15/2018 |
Last Update Date | 03/17/2018 |
Identifier | Type | State | Issuer |
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1407359532 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | D32036 (Maryland) | Primary |
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