| |
22 S Athol Ave Baltimore MD 21229-3405 | |
(410) 947-3052 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 22 S Athol Ave, Baltimore, Maryland |
Authorized Official Name and Position | David Birdsall (PRESIDENT) |
Authorized Official Contact | 5103502600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1601 Cummins Dr Ste D Modesto CA 95358-6411 Ph: (510) 350-2600 | 22 S Athol Ave Baltimore MD 21229-3405 Ph: (410) 947-3052 |
NPI Number | 1205212032 |
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Provider Enumeration Date | 08/04/2015 |
Last Update Date | 03/30/2020 |
Identifier | Type | State | Issuer |
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1205212032 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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