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Organization
MEDSPA M.D. LLC
Active
Organization
MEDSPA M.D. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN RENEE CLANZY M.D. (CEO)
(410) 446-2257
Entity
Organization
Contact information
Practice address
1804 W NORTH AVE, BALTIMORE, MD 21217-1621
(410) 685-6331
(410) 685-6332
Mailing address
1804 W NORTH AVE, BALTIMORE, MD 21217-1621
(410) 685-6331
(410) 685-6332
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D0060902
MD
Other
Enumeration date
07/18/2012
Last updated
12/10/2025
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