Provider First Line Business Practice Location Address:
300 ARMORY PLACE
Provider Second Line Business Practice Location Address:
SUITE 3D, ARMORY BUILDING, 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:
21212-2612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-997-0191
Provider Business Practice Location Address Fax Number:
301-997-0199
Provider Enumeration Date:
04/11/2007