Provider First Line Business Practice Location Address:
301 ST. PAUL PLACE
Provider Second Line Business Practice Location Address:
MERCY 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:
21202-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-332-9628
Provider Business Practice Location Address Fax Number:
410-332-9792
Provider Enumeration Date:
09/06/2006