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200 Font Hill Ave Baltimore MD 21223-2703 | |
(410) 843-9477 | |
(410) 843-9496 |
Full Name | |
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Speciality | Clinic/center - Student Health |
Location | 200 Font Hill Ave, Baltimore, Maryland |
Authorized Official Name and Position | Susan Marie Antol (CLINIC ADMINISTRATOR) |
Authorized Official Contact | 4107065145 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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655 W Lombard St Suite 425b Baltimore MD 21201-1512 Ph: (410) 706-5395 | 200 Font Hill Ave Baltimore MD 21223-2703 Ph: (410) 843-9477 |
NPI Number | 1275947319 |
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Provider Enumeration Date | 06/17/2014 |
Last Update Date | 06/17/2014 |
Identifier | Type | State | Issuer |
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1275947319 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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