| Innovative Mwlm LLC | |
|
5525 Eastern Ave Apt 105 Baltimore MD 21224-2796 | |
| (443) 512-8337 | |
| (443) 327-5282 |
| Full Name | Innovative Mwlm LLC |
|---|---|
| Speciality | General Practice |
| Location | 5525 Eastern Ave Apt 105, Baltimore, Maryland |
| Authorized Official Name and Position | Bryan Morrow (CEO) |
| Authorized Official Contact | 4435128337 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Mwlm LLC 9106 Philadelphia Rd Ste 208 Rosedale MD 21237-4333 Ph: (443) 512-8337 | Innovative Mwlm LLC 5525 Eastern Ave Apt 105 Baltimore MD 21224-2796 Ph: (443) 512-8337 |
| NPI Number | 1164221123 |
|---|---|
| Provider Enumeration Date | 03/12/2025 |
| Last Update Date | 03/12/2025 |
| Certification Date | 03/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164221123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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