Organization
PROSPEROUS, LLC
Active
Other names
Cedar Tree Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAM FOUZIA (MANAGING MEMBER)
(267) 559-3001
Entity
Organization
Contact information
Practice address
131 BECKS WOODS DRIVE, BEAR, MD 19701
(267) 559-3001
(302) 595-3149
Mailing address
PO BOX 1165, MIDDLETOWN, DE 19709-7165
(267) 559-3001
(302) 595-3149
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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