Organization
LAKE SHORE PHYSICIAN PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL THOMAS FOLKEMER MD (PRESIDENT)
(410) 437-3200
Entity
Organization
Contact information
Practice address
4231 POSTAL COURT, PASADENA, MD 21122
(410) 432-3200
(410) 437-9402
Mailing address
4231 POSTAL COURT, PASADENA, MD 21122
(410) 432-3200
(410) 437-9402
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D14751
MD
Other
Enumeration date
08/02/2006
Last updated
08/22/2020
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