Organization
COMMITTED TO CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJENDRA LOWTAN M.D. (MEDICAL DIRECTOR)
(410) 290-8800
Entity
Organization
Contact information
Practice address
8965 GUILFORD RD, SUITE 150, COLUMBIA, MD 21046-2384
(410) 290-8800
(410) 290-8870
Mailing address
8965 GUILFORD RD, SUITE 150, COLUMBIA, MD 21046-2384
(410) 290-8800
(410) 290-8870
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
D0058483
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403435002
—
MD
Enumeration date
04/24/2012
Last updated
04/24/2012
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