Organization
MILL STREET MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MALENA JEAN-SMITH (ADMINISTRATOR)
(301) 755-9488
Entity
Organization
Contact information
Practice address
340 MILL ST, HAGERSTOWN, MD 21740-6138
(301) 739-7100
(301) 498-1439
Mailing address
340 MILL ST, HAGERSTOWN, MD 21740-6138
(301) 739-7100
(301) 498-1439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0018019
MD
Other
Enumeration date
05/19/2015
Last updated
04/01/2016
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