# PORT RECOVERY PHYSICIANS CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124470356
- **Authorized official:** JOANNE GRANRUTH (OWNER)
- **Authorized official phone:** (410) 534-8735

## Contact information

- **Practice address:** 8615 RIDGELYS CHOICE DR STE 205, NOTTINGHAM, MD 21236-3028
- **Practice address phone:** (443) 869-4909
- **Practice address fax:** (443) 869-4928
- **Mailing address:** 8615 RIDGELYS CHOICE DR STE 205, NOTTINGHAM, MD 21236-3028
- **Mailing address phone:** (443) 534-8735
- **Mailing address fax:** (410) 534-8737

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/12/2016
- **Last updated:** 05/30/2025