# MARYLAND WOUND & AMPUTATION PREVENTION, LLC

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

## Provider details

- **NPI number:** 1134897424
- **Authorized official:** ROBERT THOMAS (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (443) 383-9300

## Contact information

- **Practice address:** 1300 YORK RD STE 200, LUTHERVILLE, MD 21093-6090
- **Practice address phone:** (443) 383-9300
- **Practice address fax:** (855) 866-8710
- **Mailing address:** PO BOX 69469, BALTIMORE, MD 21264-9469
- **Mailing address phone:** (877) 982-9227
- **Mailing address fax:** (877) 449-0702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 09/01/2021
- **Last updated:** 08/26/2022