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Individual

MR. VON MAURICE HOMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BOCPD

Contact information

Practice address
17 MISSION WOOD WAY, REISTERSTOWN, MD 21136-3651
(302) 983-9705
(866) 443-2024
Mailing address
17 MISSION WOOD WAY, REISTERSTOWN, MD 21136-3651
(302) 983-9705
(866) 443-2024

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
C36341
MD
213E00000X
Podiatrist
Primary
C36341
MD
213ES0000X
Sports Medicine Podiatrist
C36341
MD

Other

Enumeration date
01/22/2009
Last updated
01/22/2009
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