| |
22 S Athol Ave Baltimore MD 21229-3405 | |
(410) 766-1995 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 22 S Athol Ave, Baltimore, Maryland |
Authorized Official Name and Position | Krystle D Brown (BILLING MANAGER) |
Authorized Official Contact | 4108006251 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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22 S Athol Ave Baltimore MD 21229-3405 Ph: (410) 766-1995 | 22 S Athol Ave Baltimore MD 21229-3405 Ph: (410) 766-1995 |
NPI Number | 1447076203 |
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Provider Enumeration Date | 11/26/2024 |
Last Update Date | 11/26/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447076203 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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