Organization
PREMIER MEDICAL GROUP OF MARYLAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY FAKOREDE MD (MD)
(410) 709-7432
Entity
Organization
Contact information
Practice address
10705 CHARTER DR STE 350, COLUMBIA, MD 21044-2995
(410) 709-7432
Mailing address
10705 CHARTER DR STE 350, COLUMBIA, MD 21044-2995
(410) 709-7432
(410) 862-2592
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
09/23/2025
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