# HORMONES & IMMUNOLOGY PERSONALIZED MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HORMONES & IMMUNOLOGY PERSONALIZED MEDICINE
- **Other names:** H&I Personalized Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033821830
- **Legal business name:** HORMONES & IMMUNOLOGY PERSONALIZED MEDICINE
- **Authorized official:** LAVON MAGRUDER CRNP (OWNER)
- **Authorized official phone:** (443) 204-1134

## Contact information

- **Practice address:** 100 OWINGS CT STE 12, REISTERSTOWN, MD 21136-6434
- **Practice address phone:** (443) 204-1134
- **Mailing address:** 9954 SHOSHONE WAY, RANDALLSTOWN, MD 21133-1739
- **Mailing address phone:** (443) 204-1134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/23/2022
- **Last updated:** 02/09/2023