Organization
GRACEWAY HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTLE BROWN (PRACTICE ADMINISTRATOR)
(410) 800-6251
Entity
Organization
Contact information
Practice address
1222 TUGWELL DR, CATONSVILLE, MD 21228-5847
(667) 300-8222
Mailing address
10259 CABERY RD, ELLICOTT CITY, MD 21042-1605
(410) 870-9380
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/21/2022
Last updated
11/21/2024
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