Ellicott City Primary Care Medicine Pa

NPI 1033391081 - Internal Medicine - 207R00000X

NPI Details
NPI 1033391081
Enumeration Date 12/02/2007
Last Updated 09/17/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CHARLES EDWARD CHARLES
Position PRESIDENT
Phone (410) 465-1091
Fax (410) 465-8129
Practice Location
10298B BALTIMORE NATIONAL PIKE
ELLICOTT CITY MD, 21042-3670, US
Phone (410) 465-1091
Fax (410) 465-8129
Business Location
10298B BALTIMORE NATIONAL PIKE
ELLICOTT CITY MD, 21042-3670, US
Phone (410) 465-1091
Fax (410) 465-8129
Toxanomy
Taxonomy Code 207R00000X
License State Maryland
License Number D0028246
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According to our database, Ellicott City Primary Care Medicine Pa NPI is 1033391081, taxonomy code is 207R00000X and license number is D0028246, license state is located at Maryland. Ellicott City Primary Care Medicine Pa physically located at 10298b Baltimore National Pike, Ellicott City MD, 21042-3670. NPI Number 1033115704 has the healthcare provider type.

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1033391081 NPI number is provided on an as is basis without warranty of any kind. 1033391081 is maintained by the National Plan & Provider Enumeration System. The contents of Ellicott City Primary Care Medicine Pa are for informational purposes only.