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Organization
ST. MARY'S HEALTH DEPARTMENT
Active
Organization
ST. MARY'S HEALTH DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL WAYNE BRIDGETT I CRNP (CRNP)
(301) 475-4330
Entity
Organization
Contact information
Practice address
21580 PEABODY ST, LEONARDTOWN, MD 20650-2962
(301) 475-4330
(301) 475-4383
Mailing address
21580 PEABODY ST, LEONARDTOWN, MD 20650-2962
(301) 475-4330
(301) 475-4383
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
R096847
MD
261QC1500X
Community Health Clinic/Center
R096847
MD
Other
Enumeration date
02/14/2011
Last updated
02/14/2011
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