| Md002g | |
|
2401 Brandermill Blvd Ste 330 Gambrills MD 21054-1604 | |
| (410) 224-4887 | |
| Not Available |
| Full Name | Md002g |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 2401 Brandermill Blvd Ste 330, Gambrills, Maryland |
| Authorized Official Name and Position | Alan Oliver (CEO) |
| Authorized Official Contact | 7865303820 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Md002g 2401 Brandermill Blvd Ste 330 Gambrills MD 21054-1604 Ph: (410) 224-4887 | Md002g 2401 Brandermill Blvd Ste 330 Gambrills MD 21054-1604 Ph: (410) 224-4887 |
| NPI Number | 1124857214 |
|---|---|
| Provider Enumeration Date | 07/29/2024 |
| Last Update Date | 05/15/2025 |
| Certification Date | 05/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124857214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | () | Primary |
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