Organization
WATCHEMSPROUT PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY T REUS CRNP (NURSE PRACTITIONER)
(410) 433-0801
Entity
Organization
Contact information
Practice address
1190 W NORTHERN PKWY, SUITE 101, BALTIMORE, MD 21210-1431
(410) 433-0801
Mailing address
1190 W NORTHERN PKWY, SUITE 101, BALTIMORE, MD 21210-1431
(410) 433-0801
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R146510
MD
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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