Organization
MARYLAND WOUND & AMPUTATION PREVENTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT THOMAS (CREDENTIALING SPECIALIST)
(443) 383-9300
Entity
Organization
Contact information
Practice address
1300 YORK RD STE 200, LUTHERVILLE, MD 21093-6090
(443) 383-9300
(855) 866-8710
Mailing address
PO BOX 69469, BALTIMORE, MD 21264-9469
(877) 982-9227
(877) 449-0702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
09/01/2021
Last updated
08/26/2022
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