Organization
HORMONES & IMMUNOLOGY PERSONALIZED MEDICINE
Active
Parent organization
HORMONES & IMMUNOLOGY PERSONALIZED MEDICINE
Other names
H&I Personalized Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
HORMONES & IMMUNOLOGY PERSONALIZED MEDICINE
Authorized official
LAVON MAGRUDER CRNP (OWNER)
(443) 204-1134
Entity
Organization
Contact information
Practice address
100 OWINGS CT STE 12, REISTERSTOWN, MD 21136-6434
(443) 204-1134
Mailing address
9954 SHOSHONE WAY, RANDALLSTOWN, MD 21133-1739
(443) 204-1134
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/23/2022
Last updated
02/09/2023
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