Provider First Line Business Practice Location Address:
6701 N CHARLES ST
Provider Second Line Business Practice Location Address:
GREATER BALTIMORE MEDICAL CENTER
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-6808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-849-2983
Provider Business Practice Location Address Fax Number:
410-849-3776
Provider Enumeration Date:
04/16/2012