Organization
MEDSTAR MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC R. WAGNER (EXECUTIVE VICE PRESIDENT)
(410) 772-6595
Entity
Organization
Contact information
Practice address
2021 K ST NW, SUITE 310, WASHINGTON, DC 20006-1003
(202) 429-2401
(202) 429-4341
Mailing address
8094 SANDPIPER CIR, SUITE O, BALTIMORE, MD 21236-4907
(410) 933-3017
(410) 933-3019
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/21/2011
Last updated
02/20/2012
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