| Queen Anne's Medical Center, Llc | |
|
2108 Rear Didonato Drive Chester MD 21619 | |
| (410) 643-6205 | |
| (410) 643-6945 |
| Full Name | Queen Anne's Medical Center, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2108 Rear Didonato Drive, Chester, Maryland |
| Authorized Official Name and Position | Gary John Sprouse (PHYSICIAN) |
| Authorized Official Contact | 4106436710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Queen Anne's Medical Center, Llc 2108 Rear Didonato Drive Chester MD 21619 Ph: (410) 643-6710 | Queen Anne's Medical Center, Llc 2108 Rear Didonato Drive Chester MD 21619 Ph: (410) 643-6205 |
| NPI Number | 1407359532 |
|---|---|
| Provider Enumeration Date | 03/15/2018 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407359532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D32036 (Maryland) | Primary |
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