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Organization
SOUTH RIVER INTERNAL MEDICINE, PA
Active
Organization
SOUTH RIVER INTERNAL MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE LYNN NYE (AMA/FRONT OFFICE MANAGER)
(410) 956-1600
Entity
Organization
Contact information
Practice address
3168 BRAVERTON ST STE 250, EDGEWATER, MD 21037-2682
(410) 956-1600
(410) 956-7900
Mailing address
3168 BRAVERTON ST, SUITE 250, EDGEWATER, MD 21037-2674
(410) 956-1600
(410) 956-7900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D58166
MD
Other
Enumeration date
11/13/2008
Last updated
09/02/2024
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