Organization
UNIVERSITY OF MARYLAND FAMILY MEDICINE ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY A. MADDOCK (SENIOR ADMINISTRATOR)
(410) 328-2832
Entity
Organization
Contact information
Practice address
29 S PACA ST, BALTIMORE, MD 21201-1771
(410) 328-2832
Mailing address
PO BOX 64380, BALTIMORE, MD 21264-4380
(413) 328-2832
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050550100
—
MD
05
—
912311300
—
MD
Enumeration date
06/10/2008
Last updated
10/29/2008
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