# INNOVATIVE MWLM LLC

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

## Provider details

- **NPI number:** 1164221123
- **Authorized official:** BRYAN MORROW (CEO)
- **Authorized official phone:** (443) 512-8337

## Contact information

- **Practice address:** 5525 EASTERN AVE APT 105, BALTIMORE, MD 21224-2796
- **Practice address phone:** (443) 512-8337
- **Practice address fax:** (443) 327-5282
- **Mailing address:** 9106 PHILADELPHIA RD STE 208, ROSEDALE, MD 21237-4333
- **Mailing address phone:** (443) 512-8337
- **Mailing address fax:** (443) 327-5282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/12/2025
- **Last updated:** 03/12/2025