Provider First Line Business Practice Location Address:
21 S GREENE STREET
Provider Second Line Business Practice Location Address:
UNIVERSITY OF MARYLAND MEDICAL CENTER
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-328-5382
Provider Business Practice Location Address Fax Number:
410-328-5481
Provider Enumeration Date:
07/20/2007