Provider First Line Business Practice Location Address:
827 LINDEN AVENUE
Provider Second Line Business Practice Location Address:
MARYLAND GENERAL HOSPITAL
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:
410-328-7037
Provider Business Practice Location Address Fax Number:
410-328-3311
Provider Enumeration Date:
09/20/2012