Organization
BAYSIDE PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH R BROWER CRNP (OWNER)
(410) 414-5633
Entity
Organization
Contact information
Practice address
301 STEEPLE CHASE DR, STE 103, PRINCE FREDERICK, MD 20678-4049
(410) 414-5633
(410) 414-5911
Mailing address
301 STEEPLE CHASE DR, STE 103, PRINCE FREDERICK, MD 20678-4049
(410) 414-5633
(410) 414-5911
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R126934
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410114600
—
MD
Enumeration date
03/29/2007
Last updated
05/27/2014
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