# OPAL MEDICAL GROUP, P.A.

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

## Provider details

- **NPI number:** 1477639862
- **Authorized official:** MRS. AMY RENEE HOSE (OFFICE MANAGER)
- **Authorized official phone:** (240) 420-6909

## Contact information

- **Practice address:** 1126 OPAL COURT, HAGERSTOWN, MD 21740
- **Practice address phone:** (240) 420-2666
- **Practice address fax:** (240) 420-0951
- **Mailing address:** 1126 OPAL COURT, HAGERSTOWN, MD 21740
- **Mailing address phone:** (240) 420-2666
- **Mailing address fax:** (240) 420-0951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D52323 | MD | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 02/24/2010