Provider First Line Business Practice Location Address:
22 S GREENE ST
Provider Second Line Business Practice Location Address:
ANESTHESIOLOGY, S8C00
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:
410-328-1239
Provider Business Practice Location Address Fax Number:
410-328-0546
Provider Enumeration Date:
05/19/2009